Faye Abdellah

21 NURSING PROBLEMS
Faye Glenn Abdellah
was one of the most
influential nursing
theorist and public
health scientists .
 Background
• Born -
March13.1919
Where?
• Nursing Diploma
from Fitkin
Memorial Hospital
Where?
 May 6, 1937
• German hydrogen-fueled
airship Hindenburg
exploded in Lakehurst, New
Jersey

• "I could see people jumping

from the zeppelin and I
didn't know how to take
care of them, so it was then
that I vowed that I would
learn nursing."
 Background
Columbia University
• Bachelors Degree
in Nursing 1945
• Masters Degree in
Physiology 1947
• Doctorate in
Education 1955
Accomplishments (McEwen, 2007)
• U.S. Public Health Service (Branch of Military)
• Chief Nurse Officer
• First Deputy U.S. Surgeon General
• Uniformed Services University of Health
Sciences
• Founder and First Dean, Graduate School of
Nursing
• Yale University School of Nursing
• Nursing Instructor
 Known as :
• Nursing researcher and
theorist

• “First woman to
become a surgeon
general as a nurse”
 Faye G. Abdellah’s Theory
• Abdellah’s theory, “Nursing is based
1960
on an art and science that moulds
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.”
• Originated from nursing practice & desire to
promote patient-centered comprehensive
care
.
METAPARADIGM
 Man /Person
• Having physical, emotional,
and sociological needs.
• Needs may be OVERT
largely physical needs
• COVERT  emotional,
sociological and
interpersonal needs- which
are often missed and
perceived incorrectly.
 Nursing
Responsibilities
Effective communication between
patient and caregiver. Information is
accurate, timely and appropriate.

Do everything possible to alleviate

patients’ pain and make them feel
comfortable.

We provide emotional support and

alleviate fears and anxiety.

We involve family and friends in every

phase of our patients’ care.
• Patient is
described as the
only justification
for the existence of
nursing.
 Health
• Does not give a
definition of health
• “Total health needs”
and “a healthy state
of mind and body” in
her description of
nursing as a
comprehensive service.
 Environment/ Society
• Home or community from
which patient comes.

• Society is included in
“planning for optimum
health on local, state,
national and international
levels.”
 Nursing

• “Nursing is based on an art and science that mold

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”
• Comprehensive nursing service
 Nursing
• Service to individuals,
to families and
therefore to society.
• Goal of nursing is the
fullest physical,
emotional, intellectual,
social and spiritual
functioning of the
client which pertains to
holistic care.
 11 Nursing Skills
1. Observation of health
status
2. Skills of communication
3. Application of
knowledge
4. Teaching of patients
and families
5. Planning and
organization of work
6. Use of resource
materials
7. Use of personnel
resources
8. Problem-solving
9. Direction of work of
others
10. Therapeutic use of
the self
11. Nursing procedures
 Abdellah’s Theory and Nursing
Influence

Physiologic

Psychological
PATIENT Sociologic
 four categories of patient needs

• Basic to all patients

• Sustenal care needs
• Remedial care needs
• Restorative care
needs.
Twenty-One Nursing
Problems
- Serve as a knowledge base for nursing

Categorized according to needs)

(
 BASIC TO ALL PATIENTS
1. To maintain good hygiene and physical comfort –
After colonoscopy, patients are usually soiled from the
procedure. It is therefore important to clean them
properly. Physical comfort through proper positioning
in bed.
2. To promote optimal activity: exercise, rest, and
sleep – Patients who were sedated during the
procedure stay in the unit until the effect of the
sedation has decreased to a safe level. As a nurse,
make sure the patients are able to rest and sleep well
by providing a conducive environment for rest, such as
decreasing environmental noise and dimming the light
if necessary.
3. To promote safety through prevention of accident,
injury, or other trauma and through the prevention of
the spread of infection – one way we prevent the
spread of infection is through proper disinfection of
the equipments . Bed alarm , call light at all times
4. To maintain good body mechanics and prevent and
correct deformity – Positioning the patient properly,
allowing for the normal anatomical position of body
parts.
5. facilitate the maintenance of a supply of oxygen to all body cells –
when patients manifest breathing problems, oxygen is attached to
them. Sedated patients are attached to cardiac monitor and pulse oxi
meter while having the oxygen delivered. When the oxygen
saturation falls below the normal levels, the rate of oxygen is
increased accordingly, as per physician's order.

6. To facilitate the maintenance of nutrition of all body cells –

patients undergoing endoscopic procedures are on NPO. For this
reason it is important to monitor the blood glucose level. When the
patient's blood glucose falls from the normal value, we inject D50W
to the patient or we change the patient's IVF to a dextrose containing
fluid.
7. To facilitate the maintenance of elimination – Providing
bedpans or urinals to patients and at times, insertion of Foley
catheter when the patient is not able to void

8. To facilitate the maintenance of fluid and electrolyte

balance – Proper regulation of the intravenous solutions .
9. To recognize the physiological responses of the body to
disease conditions—pathological, physiological, and
compensatory – ex. Pt. with DENGUE-it is important to check
the patients for signs of bleeding by monitoring the BP, capillary
refill

10.To facilitate the maintenance of regulatory mechanisms and

functions – When a patient has a difficulty in breathing and is
showing an increase respiratory rate, elevating the head part of
the bed is done to facilitate the respiratory function.
 11. To facilitate the maintenance of sensory function –
When a patient is admitted who is already deaf and mute, we
communicate to them by body language to maintain their basic
need despite of inadequacy to the sensory function.

Communicate to comatose patient

12. To identify and accept interrelatedness of emotions and organic
illness – Encourage patients to verbalize their feelings and allow
them to cry when they have the need to do so will help them
emotionally. Some patients are diagnosed with malignancy after
the procedure and during this time the emotional needs of the
patient is a priority.
13. To identify and accept
positive and negative
expressions, feelings, and
reactions – most patients feel
anxious before undergoing the
procedures. It is necessary to
listen to the patients' expressions
and allow them to ask questions.
to decrease their anxiety.
14. To facilitate the maintenance of effective verbal and
nonverbal communication – when patients are not able to
express themselves verbally, it is important to assess for
nonverbal cues. For instance when patients are in pain, assessing
for facial grimacing.
15. To promote the development of productive interpersonal
relationships – allow the patient's significant others to stay with
the patient before and after the procedure. This allows for
bonding and promotes interpersonal relationship.
16. To facilitate progress toward achievement of personal
spiritual goals – nurse usually visits the patients in the unit.
Patients may benefit from this, allowing them time to practice
their faith.

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

providing proper lighting, proper room temperature, a quiet
environment are done to patients staying in the unit.
18. To facilitate awareness of self as an individual with varying
physical, emotional, and developmental needs – care to
patients vary according to their developmental needs. Allowing
the parents to stay during the procedure help the pediatric
patients in their emotional and developmental needs.
19. To accept the optimum possible goals in the light of
limitations, physical, and emotional – The goals for each patient
vary depending on the capability of the patient. The nutritional
goal for a patient with a PEG tube for instance will be different,
knowing that the patient has limited feeding options.

20. To use community resources as an aid in resolving problems

arising from illness – Some patients live far from the city and
thus referral to health centers is sometimes done.
- support groups for depressed patients
- Shelter homes for victims of abuse
21. To understand the role of social problems as influencing
factors in the cause of illness – Some patients who are
diagnosed with amoebic colitis for instance are advised to avoid
buying street foods to which the preparation they are not sure
of, and also avoid drinking water that are not safe.
 10 Ways to Identify a
Client’s Problem
 Learn to know the patient
 Continue to observe and evaluate
 Sort out relevant and significant data the patient over time to identify any
attitudes and clues affecting his
behavior
 Analyze and make generalizations
about available data
 Explore the patient’s and family’s
reaction to the therapeutic plan and
 Identify the therapeutic plan involve them in the plan

 Test generalizations with the patient  Identify how the nurse feels about
and make additional generalizations the patient’s nursing problems

 Validate the patient’s conclusion about  Discuss and develop a

his nursing problems comprehensive nursing care plan
 CHARACTERISTICS

Abdellah’s theory has interrelated the

concepts of health, nursing problems and
problem solving as she attempts to create
a different way of viewing nursing
phenomenon.
 LIMITATIONS
The major limitation of Abdellah theory and
the twenty one nursing problems is their very
strong nursing centered orientation. With the
orientation appropriate use might be the
organization of teaching content for nursing
students, the evaluation of a students,
performance in the clinical area or both. But
in terms of client care there is little emphasis
on what the client is to achieve.
 CONCLUSION
Using Abdellah’s concepts of health, nursing
problems, and problem solving, the theoretical
statement of nursing that can be derived is the use of
the problem solving approach with key nursing
problems related to health needs of people. From
this framework, 21 nursing problems were
developed.
Abdellah’s theory provides a basis for determining
and organizing nursing care. The problems also
provide a basis for organizing appropriate nursing
strategies.
 Applying Abdellah’s Theory to
Current Nursing Practice
• Marie:
• Abdellah’s “Ten Ways of Identifying a Client’s
• I find that parts of the theory fit my physician
Problem” is utilized in the clinical setting and
office work well as it states that it “aims to help
are necessary in initiating and implementing
people, sick or well, cope with their health
the nursing care plan.
needs” (Nursing Theories, 2010) and that is the
goal of primary care in physician offices.
• The 21 nursing problems are relevant to the
office setting just as they are to the hospital. • Nursing programs encourage nursing students
to utilize patient- centered approaches in the
clinical setting
• Keesha
• In the critical care setting, my current practice
has shifted from nursing care exclusive to the
disease to addressing the patient’s immediate • Problem solving approach is utilized by
health care needs. Abdellah’s Theory equips me practitioners in guiding treatment plans within
with specific guidelines as to how I can better their practice. Especially within practices that
manage a variety of patient conditions in the deals with clients who have specific health care
ICU. needs and specific nursing problems
• (Nursing Theories, 2010)