MICRO TEACHING

on
meningitis
SUBMITTED TO : SUBMITTED BY:
Mr. VASANTH KUMAR.C Ms. VIMALA PORTE
ASSIST-PROFESSOR M.Sc.NURSING1ST YEAR
DEPT. OF M.S.N. RITcon
RITcon
 ABDELLAH’S THEORY

Subject : Advance Nursing Practice

Topic : Abdellah’s Theory

Method of teaching : Lecture, explanation and discussion

Learning activity : active listening, discussion, questioning

Audio visual aids : Chalk board, flip chart, flash card, chart, power point, bulletin board

Date :

Time : 1hrs

Venue : Classroom

Name of the teacher : Heena Anjum

Previous level of knowledge : Students are not aware about Abdellah’s Theory
General Objective:-

At the end of class, student will be able to acquire adequate knowledge regarding ‘Abdellah’s Theory’ and will be able to apply this
knowledge in theoretical as well as clinical setting with positive attitude.

Specific Objective:-

At the end of class, student will be able to understand

1. Introduction of Abdellah’s Theory.

2. Concepts of Abdellah’s Theory.
3. Twenty one nursing problem of Abdellah’s Theory
4. Paradigm of Abdellah’s Theory.
5. Abdellah criterion for effective patient care
6. Critique of Abdellah’s Theory.
7. Strehght and limitation of Abdellah’s Theory
Time Specific Content Teaching Learning Av aids Evaluation
Objective activity activity
5 min Introduce the INTRODUCTION:- Explanation Active listening Power point Are u know
Abdellah Abdellah
Faye Glenn Abdellah was born in New York city in
Theory Theory
1919.A 1942 Magna cum Laude graduate of fitkin
?
Memorial Hospital school of Nursing(now Ann May

school of nursing),she received her Bs,MA and EdD from

Teacher college at Columbia University. she completed her

Doctorate work in 1955.

Dr. Abdellah served as Deputy surgeon General and

as chief nurse officer U.S public health service

(USPHS) ,department of health and human services,

Washington, D.C. she retired from the USPHS with the

rank of rear admiral. In 1993 she becomes Dean of the

newly formed graduate school of nursing, uniformed

services university

of the health sciences. She has more than 140 publications

related to nursing care, education for advanced practice in

nursing ,health care administration ,and nursing research.

Some of these have been translate into six languages.

She has been granted 11 honorary doctorates by

various institutions, including case reverse, Rutgers,

university of Akron, catholic university of America,

Eastern University, and Monmoth college. These honors

recognized her work in nursing research, development of

the first nurse scientist training program, expertise in health

policy, as well as her outstanding contribution to the health

of nation.

Her international service includes delegation

member to the USSR, Yugoslavia, France, and the people

Republic of China; coordinator of the US-Argentina

cooperation in health and medicine Research project;

consultant to Portugal for program development for the

disabled and elderly, to Tel Aviv university on long- term

care and nursing education and research and in Australia

and New Zealand in relation to nursing home care, nursing

education, and research. has also been a research

consultant to the world health organization.

In 1960, influenced by the desire to promote patient

centered comprehensive nursing care ,Abdellah described

nursing as a service to the individuals, to families and

therefore, to society. According to Abdellah nursing is

based on the art and science that mould the attitudes,

intellectual competencies, and technical skill of the

individual nurse into the desired and ability to help people

sick or well, cope with their health needs. Nursing may be

carried out under general or specific medical direction. As

a comprehensive service, nursing includes the following-:

1. Recognizing the nursing problem of the patient.

2. Deciding the appropriate course of action to take in

term of relevant nursing principles.

3. Providing continuous care of the individual’s total

health need.

4. Providing continuous care to relieve pain and

discomfort and provide immediate security for the

individual.

5. Adjusting the total nursing care plan to meet the

patient’s individual need.

6. Helping the individual to become more self

directing in attaining or maintaining a healthy state

of mind and body.

7. Instructing nursing personal and family to help the

individual do for himself that which he can within

his limitation.
 8. Helping the individual to adjust to his limitations

and emotional programs.

9. working with allied heath profession in planning

for optimum health on local, state, national and

international levels ;and

10. carrying out continuous evaluation and research to

improve nursing techniques and to develop new

techniques to meet the health needs of people.

These original premises have undergone an evolutionary

process. As a result,in 1973,Item 3-“providing continuous

care of the individual’s total need”-was eliminated.

Although no reason was given it can be hypothesized that

the words continuous and total render that service virtually

impossible to provide. Form these premises, Abdellah’s

theory was derived.

10
min . CONCEPTS USED BY ABDELLAH
To explain the Explanation Active listening Power point To explain
NURSING-: Abdellah defines nursing as “service to
concept of the concepts
individuals”. it is based upon an art and science which
Abdellah of Abdellah
Theory mould the attitudes, intellectual competence, and technical theory ?

skills of the individual nurse into the desire and ability to

help people sick or well cope with health needs and may be

carried general or specific medical direction.

Abdellah was clearly promoting the image of the nurse

who was not only kind and caring, but also intelligent,

competent and technically well prepared to provide service

to the patient.

HEALTH -:Although Abdellah never define it per se , her

concept of health may be inferred to be the dynamic pattern

of functioning whereby there is a continued interaction

with internal and external force that result in optimal use of

necessary resources that serve to minimize vulnerabilities.

Emphasis should be placed on prevention and

rehabilitation with wellness as life time goal. By

performing nursing service through a holistic approach to

the patient, the help the patient achieve a state of health.

However ,to effectively perform these service the nurse

must accurately identify the lack or deficit regarding

health that the patient is experiencing. These lack or

deficits are the patient’s health need.

NURSING PROBLEM -:The patient’s health need can be

viewed as problem, which may be overt as apparent

condition, covert as an hidden or concealed one.Because

covert problem can be emotional, social, sociological and

interpersonal in nature, they often missed or perceived

incorrectly. Yet, in many instance, solving he covert

problem may solved the covert problem as well.

Such a view of problem implies a patient – centered

orientation. Abdellah however, seems to nursing problem

presented by a patient is a condition faced by the patient, or

patient family that the nurse, through the performance of

professional function, can assist them to meet .Abdellah

use of the term nursing problem can be interpreted as more

consist with the “ nursing functions” or “ nursing goal”

then with patient centered problems. This view point could

lead to an orientation that is more nursing centered than

patient centered.

Such a nursing – centered orientation to patient care

seems contrary to the patient centered approach that

Abdellah professes to uphold .the apparent contradiction

can be explained by her desire to move away from the

disease centered, overt problem, and procedural orientation

for nursing. In her attempt to bring nursing practice into its

proper relationship with restorative and preventive measure

for meeting total patient need, she seem to swing the

pendulum to the opposite pole, from the disease orientation

to a nursing orientation , while leaving the patient

somewhere in the middle.

PROBLEM SOLVING -: Quality professional nursing

care requires that nurse be able to identify and solve overt

and covert nursing problems. These requirement can be

meet by the problem- solving approach .the problem

solving process involves identifying the problem, selecting

pertinent data , formulating hypothesis, testing hypothesis

through the collection of data and revising hypothesis when

necessary on the basis of conclusion obtained from the

data.

Many of the steps parallel the steps of the nursing process

of assessment diagnosis, outcome, planning,

implementation and evaluation. The problem –solving

 approach was selected because of the assumption that the

correct identification of nursing problem influences the

judgment in selecting the next steps in the problem solving

the patient nursing problems. Abdellah supported the use

of problem –solving process before the nursing process

was developed.
10
min To explain THE TWENTY - ONE NURSING PROBLEM
Explanation Active listening Flash card
twenty one The crucial element within Abdellah’s theory is the correct
What is
nursing identification of nursing problems . To assist in
twenty one
problem of identification, the need was defined for a systematic
nursing
Abdellah’s classification of nursing problems could be classified into
problem of
theory the following three major categories-:
Abdellah’s
1. Physical ,sociological and emotional need of the
theory?
patient.

2. Types of interpersonal relationship between the

nurse and the patient ; and

 3. Common element of patient care.

Over a five Year of period, several studies were carried

out to establish the classification . As a result of this

research, 21 groups of common problems of Abdellah’s

that are most widely known, and they are the focus of the

rest of the chapter.

These 21 problems focus on the Physical, biological and

sociopsychological need of the patient and attempt to

provide more meaningful basis for the organization than

the categories of system of the body. The 21 nursing

problem are-:

1) To maintain good hygiene and physical comfort.

2) To provide optimal activity, exercise, rest, and

sleep.

3) To promote safety through the prevention of

accident, injury, or other trauma and through the

 prevention of spread of infection.

4) To maintain good body mechanics and prevention

and correct deformities.

5) To facilitate the maintenance of a supply of oxygen

to all body cell.

6) To facilitate the maintenance of nutrition of all

body cells

7) To facilitate maintenance of elimination.

8) To facilitate maintenance of fluid and electrolyte

balance.

9) To recognize the physiological responses of the

body to disease conditions- pathological

physiological and compensatory.

10) To facilitate the maintenance of regulatory

mechanism and functions.

11) To facilitate the maintenance of sensory function.

12) To identify and accept positive and negative

expression , feeling 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 relationship.

16) To facilitate progress towards achievement of

personal spiritual goals.

17) To create and /maintain a therapeutic environment.

18) To facilitate awareness of self as an individual with

varying, physical, emotional, and development

need.

19) To accept the optimum possible goal 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 factor in the cause of illness.

Within the practice of nursing, it was anticipated that 21

problem as board grouping would encourage the generation

of principles and would theory guide care and promote the

development of the nurses judgment ability in each of the

broad nursing problem are numerous specific overt and

10 covert problem.
min To explain
PARADIGM OF ABDELLAH’S TYPOLOGY
Paradigm of Discussion Active listening Charts
Abdellah does not clearly specify each of the four
Abdellah’s
theory major concept ; Human being, health, environment /society Describe

and nursing. Paradigm of

Abdellah’s

HUMAN BEING –: She describe the recipient of nursing theory ?

as individual (and families) although she not delineate her

beliefs or assumption about the nature of human beings.

She describes people as having physical, emotional, and

sociological need. These may be overt, consisting largely

physical need. The topology and nursing problem is said to

evolve from the recognition of a need for patient is

described as the only justification for the existence of

nursing. People are helped by the identification &

alleviation of problems they are experiencing.

HEALTH -: As Abdellah discuss in “patient –centered”

approaches to nursing in a state mutually exclusive of

illness. Health is defined implicitly as a state when the

individual has no unmet needs and no anticipated or actual

impairments. Achieving the health is the purpose of

nursing services. Although Abdellah does not given the

definition of health, she speaks of total health needs, and

the healthy state of mind and body’ in her description of

nursing as a comprehensive nursing service.

ENVIRONMENT -: The environment is least discussed

concept in her model. Nursing problem 17 from the

typology is “to create and/or maintain a therapeutic

environment and she also state that if the nurse reaction to

the patient is hostile or negative, the atmosphere in the

room may be hostile or negative .this suggests that patient

interest and respond to the environment. Society is

included in the premises of comprehensive nursing care,

that is planning for optimum health on local state, nation

and international.

NURSING -: Nursing is broadly grouped into the 21

problem area to guide care and promote the use of nursing

judgment. Abdellah considersbeing comprehensive service

that is based on the art and science and aims to help people,

sick or well, with their health their need.

NURSING PROCESS

Abedellah’s typology of 21 nursing problems, helps

nurses practice in an organized systematic way. The use of

this scientific base enables the nurses to understand the

reason for her action. Their use in the nursing process is

primarily to direct the nurse indirectly to the client’s

benefits.

ASSESSMENT -: The nursing problem provide guidelines

for the data collection. A principle underlying the problem-

solving approach is that for each identified problem,

pertinent data are collected .Thus for each of the identified

21 nursing problems necessitates a direct approach ,

retrospectively .For example the overt problem of

nutritional status can be assessed by direct measure of

weight, food intake & body size ,whereas the covert

problem of maintaining a therapeutic environment requires

more direct approaches to data collection. These might

include observation of such aspect as situation in which the

patient is tense and those in which the patient is relaxed.

The nursing problem can be divided into those that

are basic to all patient and those that reflect sustenal,

remedial or retrospective care need

1. Basic to all client -: include 1-4 nursing problem of

Abdellah list of 21 problems.

2. Sustenal care need -: 5-11 nursing problem.

3. Remedial care need -: 12 -19

4. Restorative care need -: 20 and 21 point of nursing

problems.

NURSING DIAGNOSIS -: The result of the data

collection would determine the patient’s specific overt

and /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. Within this framework, the nursing

diagnosis is derived from the exhibited nursing problem.

PLANNING -:The 21 nursing problems can have a great

impact on the outcome and planning phase of the nursing

process. The statement of the nursing problems contain the

basis for desired outcomes and most closely resemble goal

statements. Therefore once the problem was diagnosed, the

outcome have been established. Many of the nursing

problems statements can be considred goal of either the

nurse or the these problems are called nursing problems,

that it could be reasonable to conclude that these goals are

basically nursing goals.

 In implementation, nurse using the goals as the

framework, a plan is developed and appropriate nursing

intervention are determined. Again holism tends to be

negated in implementation because of isolation particular

nature of the nursing.

EVALUATION -:The plan is evaluated in terms of

client’s progress towards the achievement of the goal.

10min
To point out
ABDELLAH’S CRETERION FOR EFFECTIVE
Abdellah’s
PATIENT CENTERED CARE Explanation Active listening Power point
criterion for
Abdellah’s suggested the following criteria might be
effective
What are the
used to determine the effectiveness of patient centered
patient
Abdellah’s
care-:
centered care
criterion for
1. The patient is able to provide for the satisfaction of
effective
his own needs.
patient
2. The nursing care plan makes provision to meat four
 needs- sustental care, remedial care, restorative care centered care

and preventive care. ?

3. The care plan extends beyond the patient’s

hospitalization and makes provision for

continuation of the care at home.

4. The level of nursing skill provided varies with the

individual patient care requirement.

5. The entire care plan is directed at having the patient

help himself.

6. The care plan makes provision for involvement of

member of the family throughout the

hospitalization and after discharge.

10
min To explain
critique of CRITIQUE OF ABDELLAH’S Active listening Power point
Lecture cum
Abdellah
Theory 1. WHAT IS THE HISTORICAL CONTEXT OF disscussion
Explain
THE THEORY?-:
critique of
An examination of 21 problems yields similarities
Abdellah
to the other theories. Most notable is the similarities to Theory
?
Henderson’s (1991) 14 component of basic nursing care.

Abdellah has consolidated some components and has

expanded other. The strong similarity may be result of both

Henderson’s and Abdellah’s exposure to the same

environment-Teachers college, Columbia university, New

York. It might be hypothesized that Abdellah moved from

the rather simplistic form of Henderson theory of more

complex structure.

Despite of similarity, a major difference is

evident, Henderson’s component are written in term

of patient behaviors. Whereas Abdellah’s problems

are formulated in term of the nursing services that

 should be incorporated into the determination of the

patient’s need.

Abdellah’s theory is grounded in need

theory, and is related to the frameworks of

Maslow’s hierarchy of needs and Henderson’s

basic needs.The expantion from Maslow’s five

needs and Hendrson’s 14 need to Abdellah’s 21

nursing problems demonstrates an effort to try

identify the totality of patient needs. Thus the

framework is compatible with the totality

paradigm.

2. WHAT ARE THE BASIC CONCEPTS AND

RELATIONSHIP PRESENTED BY THE

THEORY ? -:

Abdellah’s theory has interrelated the concept

of health, nursing problems, and problem solving in

 an attempt to create a different way of viewing

nursing phenomena. The resulting relationship is

the use of the problem- solving approach with key

nursing problem related to the needs of people.

3. WHAT MAJOR PHENOMENA OF CONCERN

OF NURSING ARE PRESENTED-:

The major phenomenons of concern to nursing

are the 21 nursing problems and patient- centered

care.

4. TO WHOM DOES THIS THEORY APPLY? IN

WHAT SITUATION? IN WHAT WAY?-:

Abdellah’s theory provides a basis for

determining and organizing nursing care. If all 21

problems aerated, investigated, the patient would be

likely to be thoroughly assessed. The problem also

provides a basic for organizing appropriate nursing

 strategies. it is anticipated by solving the nursing

problems, the patient would be moved towards

health. This theory applies by themselves or who

are needs of preventive care to avoid became

unable to meet those needs. Abdellah clearly states

that the nurse must be complement in working with

patient’s health needs both within the hospital and

outside it.

5. BY WHAT METHOD OR METHOD CAN

THIS THEORY BE TASTED? -:

This theory was developed through multiple

research project conducted over a five-year period.

Testing of the theory in the environment has not

been undertaken, possibly because Abdellah’s

presentation of nursing problems have focused on

 the nursing education and hospital organization.

Research question and hypothesis generated from

the theory would determine the research approach

to be used.

Abdellah’s has indicated that current nursing

research needs are to focus on evidence based

research---identify clinical practice guidelines that

identify indicators that measure quality of care---

and identify methods or instruments that monitor

the extent to which action of health care

practitioners conform to quality, and then point out

the policy implications of the research.

6. DOES THIS THEORY DIRECT CRITICAL

THINKING IN NURSING PRACTICE-:

This theory place heavy emphasis on problem

solving an activity tht is considered essential to

 critical thinking. The broad groups of 21 nursing

problems have the potential to encourage

generalization of the principles. To promote the

development of the nurses judgmental ability, and

strengthen the relationship between theory and

practice.

7.DOES THIS THEORY DIRECT THERAPEUTIC

NURSING INTERVENTIONS-:

The statement of the 21 nursing problem most

closely resemble goal statements, and as such have

the ability to directly influence nursing

interventions. The interrelationship between the

nursing problem and categories of need make a

great contribution to nursing practice with patient

specific needs. the theory focus quite heavily on

nursing practice with individuals, thereby limiting

 the potential scope of therapeutic interventions in

relations in to families and communities.

7. DOES THE THEORY DIRECT

COMMUNICATION IN NURSING

PRACTICE?-:

Given that the theory is nursing-problem

based, it has great potential for facilitating

communication in nursing practice. Indeed,

problem 14 is to facilitate the maintenance of

effective verbal and nonverbal communication.

8. DOES THIS THEORY DIRECT NURSING

ACTION THAT LEADS TO FAVORABLE

OUTCOMES-: Abdellah’s theory clearly directs

the nurse to investigate and take appropriate action

 in the 21 nursing problem area. Emphasis on the

identification of the area in which nursing help is

needed rather than specifying what the patient is to

achieve. Thus it is assumed that if the nursing

problem is resolved, then a favorable patient

outcome has been achieved, since the resolution of

the problem would indicate the patient is once again

able to meet the need.

9. HOW CONTAGIOUS IN THE THEORY?

At this time ,Adellah’s theory is not in popular

use as field of study. Its uses may be seen more in

the organization of teaching content within

educational programs, the evaluation of a student’s

performance for providing total care in the clinical

area, and the grouping of patients in clinical setting

 according to anticipated nursing needs. However, as

indicated in the biological sketch at the beginning

of this chapter. Abdellah is known internationally

for her contributions to nursing and to health

5 min To point out
policy.
the strength
STRENGTHS AND LIMITATION
and limitation Lecture cum
of Abdellah’s STRENGTHS-: discussion Active listening Power point
theory
 A major strength of Abdellah’s work is that the
Enlist
21nursing problem were developed through strength and
extensive research at least three separate research limitation of
Abdellah’s
project over a five-year period.
theory?
 The driving force behind the development of 21

nursing problems.Abdellah wanted to move nursing

care from a base in medical diagnosis and

procedures to a patient centered base.

 The importance of recognition and correctly

 identifying both covert and overt problem.

LIMITATION-:

 The major limitation is the lack of continued

research to link the effectiveness of use of 21

nursing problems to successful outcome of nursing

care.

 The label of “nursing problem” is a limitation.

Labelling list of 21 problems as nursing problems

tends to lead the reader to the belief that Abdellah’s

work is nursing centered when she started she was

seeking to move nursing to being patient centered.

Lecture cum
discussion
Active listening
Active listening
Active listening
SUMMARY :-

According to Faye Glenn Abdellah's theory, “Nursing is based on an art and science that models the attitudes, intellectual competencies, and

technical skills of the individual nurse into the desire and ability to help people, sick or well, cope with their health needs.”

CONCLUSION :-

At the end of the class teaching students get knowledge about Abdellah theory.

RECAPTUALIZATION:-

1) Define Ablellah theory ? (2)

2) What are critique of Ablellah theory ? (5)
 3) What are the strength and limitation of Ablellah theory? (5)

BIBLIOGRAPHY:-

1. BASAVANTHAPPA BT, NURSING THEORIES,FIRST EDITION,NEW DELHI,PIBLISHED BY:JAYPEE

BROTHERS MEDICAL PUBLISHER ,PAGE NO-52-60.

2. GEORGE JULIA B, NURSING THEORIES THE BASE OF PROFESSIONAL NURSING PRACTICE,3 RD

EDITION,PAG NO-171-187Sunder Lal,“TEXT BOOK OF COMMUBITY MEDICINE PREVENTIVE AND

SOCIAL MEDICINE”,5th edition, published by satish kumar jain and produced by varun jain for cbs publishers and

distributors Pvt. Ltd. page no- 276-280

3. Basavanthappa BT, “FUNDAMENTAL OF NURSING”, 2nd volume, published by jaypee brothers medical

publisher, page no- 407