A stressor that has primary impact on physiological functioning also affects the person's

psychological and sociocultural behavior. For instance, a man who had a myocardial infarction may
also become severely depressed, because he fearshe willlose his abilitytowork On the other hand,
the patient who enters the psychiatric inpatient unit with major depression may be suffering from
malnutrition and dehydration because of his refusal to eat or drink The holistic nature of nursing
encompasses all of these facets of behavior and incorporates them into patient care planning.
Nursing Process _.ursing intervention may take place at any point on the continuum. Nursing
diagnosis may focus on behavior associated with a medical diagnosis or other health behavior that
the patient wishes to change. A nurse may practice primary prevention by intervening in a potential
health problem, secondary prevention by intervening in an actual acute health problem or tertiary
prevention by mtervening to limit the disability caused by actual chronichealth problems. The
nursing assessment of the patient includes presenting complaints, ~ast history, family history,
personal history, occupational history, sexual history, physical examination and mental status
examination. _-"i.dditional data may be collected from significant Jai.ers and by reviewing the
systems. A nursing .iiagnosis is then formulated and based on this iiagnosis, planning and
interventions are carried ut. Finally, evaluation will be done to find out ::ie effectiveness of nursing
interventions. Providing nursing care is a collaborative effort, ith both the nurse and the patient
contributing -=easand energy to the therapeutic process. SUMMARY OF SELECTED RSING THEORIES
~eplau's Theory ~2Plau proposed an interpersonal theory appli- -=-...,leto nursing practice in general,
and to psychiatric-mental health nursing in particular. It focuses primarily on the nurse-client
relationship. Peplau's theory describes, explains, predicts and to some extent,permits controlofthe
sequence of events occurring in the nurse-client relationship. Peplau describes the interpersonal
aspects of nursing as a process consisting of four phases. These are orientation, identification,
exploitation and resolution phases. While working with the client through these phases, the nurse
assumes six roles: resource person, technical expert, teacher, leader, surrogate parent and a
counselor. Peplau's theory continues to apply to today's nursing scene, especially with respect to
longterm psychiatric care in outpatient and home health settings. Orem's Theory Dorothea
E.Orem'stheory isbased on the premise that people need a composite of self-care actions to survive.
Self-care actions consist of all behaviors performed by people to maintain life and health. The
capacity of the client and the client's family to perform self-care is called selfcare agency. Orem states
that a need for nursing care existsifthe client's self-care demand exceeds the client's self-care agency.
Thus the goal of nursing is to meet the client's self-care demands until the client and his family are
able to do so. Orem's theory describes three types of selfcare: 1. Universal self-carebehaviors,
required to meet physiological and psychosocial needs. 2. Developmental self-care behaviors,
required to undergo normal human development. 3. Health deviation self-carebehaviors, required to
meet client's needs during health deviations. The classification ofself-carebehaviors in this manner
helps to ensure complete assessment of the client's self-care agency. Assessment focuses on the
client's self-care demand, self-care agency and self-care deficits. A plan isformulated from the
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