Cont… NURSING THEORIES

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Faye Abdellah

TWENTY ONE
(21) Nursing
Problems Theory
🞂 Faye Glenn Abdellah was born on March 13, 1919.

🞂 Abdellah was the first nurse officer to earn the ranking of a

two-star rear admiral.

🞂 She was the first nurse and the first woman to serve as a
Deputy Surgeon General.

🞂 Her work changed the focus of nursing from disease-

centered to patient-centered, and began to include the
care of families and the elderly in nursing care.

🞂 The Patient Assessment of Care Evaluation

developed by Abdellah is now the standard used in the
United States.
According to Faye Glenn Abdellah’s
theory:

“Nursing is based on an art and science

that molds 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.”
The nursing model is intended to guide
care in hospital institutions but can also
be applied to community health nursing,
as well.

“PATIENT-CENTERED
APPROACH”-HUMAN NEED
THEORY
The 21 nursing problems fall into three
categories:

1. physical, sociological, and emotional

needs of patients
2. types of interpersonal relationship
between the patient and nurse;
3. common elements of patient care.
She used Henderson’s
14 basic human needs
and nursing research to
establish the
classification of nursing
problems.
🞂she speaks to “total health
needs” and “a healthy state of
mind and body” in her
description of nursing as a
comprehensive service.
Abdellah’s 21 Nursing Problems are the following:

1.To maintain good hygiene and physical comfort.

2.To promote optimal activity: exercise, rest, sleep
3.To promote safety by preventing accidents, injuries, or other trauma and preventing the spread of
infection.
4. To maintain good body mechanics and prevent and correct the deformity.
5. To facilitate the maintenance of a supply of oxygen to all body cells.
6. To facilitate the maintenance of nutrition for all body cells.
7. To facilitate the maintenance of elimination.
8. To facilitate the maintenance of fluid and electrolyte balance.
9. To recognize the physiologic responses of the body to disease conditions—pathologic, physiologic,
and compensatory.
10. To facilitate the maintenance of regulatory mechanisms and functions.
11.To facilitate the maintenance of sensory function.
12. To identify and accept positive and negative expressions, feelings, and reactions.
13. To identify and accept interrelatedness of emotions and organic illness.
14. To facilitate the maintenance of effective verbal and nonverbal communication.
15. To promote the development of productive interpersonal relationships.
16. To facilitate progress toward achievement and personal spiritual goals.
17. To create or maintain a therapeutic environment.
18. To facilitate awareness of self as an individual with varying physical, emotional, and
developmental 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 that arise from an illness.
21. To understand the role of social problems as influencing factors in the cause of illness.
🞂 The 11 nursing skills are:

🞂 observation of health status

🞂 skills of communication
🞂 application of knowledge
🞂 teaching of patients and families
🞂 planning and organization of work
🞂 use of resource materials
🞂 use of personnel resources
🞂 problem-solving
🞂 direction of work of others
 VIRGINIA
HENDERSON

14 Basic Human
needs
🞂 As a patient receives treatment and is on the road to
recovery, it’s important that the patient is able to take
care of him or herself after being released from medical
care
🞂 nurses should be caring for the patient while, at the
same time, be helping the patient become more
independent and reach goals and milestones on the road
to health.

🞂 Virginia Henderson’s Need Theory addresses this issue

and helps nurses help patients so that they can care for
themselves when they leave the healthcare facility.
🞂 She defined nursing as

“the unique function of the nurse is to

assist the individual, sick or well, in the
performance of those activities
contributing to health or its recovery that
he would perform unaided if he had the
necessary strength, will or knowledge. And
to do this in such a way as to help him
gain independence as rapidly as possible.”
The nurse’s goal is to make
the patient complete, whole,
or independent.
In turn, the nurse
collaborates with the
physician’s therapeutic
plan.
🞂 Henderson’s Needs Theory can be
applied to nursing practice as a way
for nurses to set goals based on
Henderson’s 14 components.

🞂 Meeting the goal of achieving the

14 needs of the client can be a great
basis to improve one’s performance
towards nursing care further.
NOLA PENDER

HEALTH
PROMOTIONAL
MODEL
⚫ The Health Promotion Model notes that each
person has unique personal characteristics and
experiences that affect subsequent actions AND
THOSE SUBSEQUENT ACTIONS ARE
MODEFIABLE.

⚫ Pender’s health promotion model defines health as “a

positive dynamic state not merely the absence of
disease.”

⚫ Health promotion is directed at increasing a client’s

level of well-being.
⚫Health promotion is defined
⚫ as behavior motivated by the desire to increase
well-being and actualize human health potential.
It is an approach to wellness.

⚫ Health protection or illness

prevention is described
⚫ as behavior motivated desire to actively avoid
illness, detect it early, or maintain functioning
within illness constraints.
⚫ Nola Pender developed her Health Promotion model,
often abbreviated HPM 🡪 after seeing professionals
intervening only after patients developed acute or
chronic health problems.

⚫ She became convinced that patients’ quality of life

could be improved by the prevention of problems
before this occurred

promotion of healthy lifestyles.

The purpose of the model

is to assist nurses in
understanding the major
determinants of health behaviors
as a basis for behavioral
counseling to promote healthy
lifestyles
Model Incorporates
a. individual characteristic \
experiences
b. behavior specific knowledge \
belief
c. motivates health promoting
behavior
Clients must be assessed accdg to:

1. Individual Characteristic and

experiences

*** if a behavior has been used before

and become a habit it is more likely to
used again.
2. Behavior specific knowledge
and belief

**** they are motivators for

engaging in health
promoting behavior
3. Health Related Behavior

****initiated by committing to a plan of

action

****accompanied by developing associated

strategies to perform and valued
behavior

****outcome of the model and directed

toward attaining positive health
outcome and experiences
throughout life.
Subconcepts:
⚫ Perceived Benefits of Action
⚫ Anticipated positive outcomes that will occur from health
behavior.

Perceived Barriers to Action

⚫ Anticipated, imagined, or real blocks and personal costs of
understanding a given behavior.

Perceived Self-Efficacy
⚫ The judgment of personal capability to organize and
execute a health-promoting behavior.
⚫ Activity-Related Affect
⚫ Subjective positive or negative feeling occurs before,
during, and following behavior based on the stimulus
properties of the behavior itself.

⚫ Interpersonal Influences
⚫ Cognition concerning behaviors, beliefs, or attitudes of
others.(norms,social support,modeling)

⚫ Situational Influences
⚫ Personal perceptions and cognitions of any given situation
or context can facilitate or impede behavior( options
available, demand characteristics , aesthetic features)
⚫ Commitment to Plan of Action
⚫ The concept of intention and identification of a
planned strategy leads to the implementation of
health behavior.
Madeleine Leininger

Transcultural
Theory
⚫ Madeleine Leininger was born on July 13, 1925, in
Sutton, Nebraska.
⚫ She lived on a farm with her four brothers and sisters
and graduated from Sutton High School.
⚫ After graduation from Sutton High, she was in the U.S.
Army Nursing Corps while pursuing a basic nursing
program.
⚫ In 1945, Madeleine Leininger, together with her sister,
entered the Cadet Nurse Corps, a federally-funded
program to increase the number of nurses trained to
meet anticipated needs during World War II.
She advocated that nursing is a
humanistic and scientific model of
helping a client through specific process
of cultural caring.

Cultural caring is cultural values,

beliefs and practice of different
nation,country or nationality that one
must know and respect.
⚫Transcultural nursing is
a study of cultures to understand
both similarities and differences in
patient groups.

⚫Culture is a set of beliefs held by

a certain group of people, handed
down from generation to
generation.
 In transcultural nursing

nurses practice according to the patient’s cultural

considerations.

It begins with a culturalogical assessment, which takes

the patient’s cultural background into consideration in
assessing the patient and his or her health.

Once the assessment is complete, the nurse should use

the culturalogical assessment to create a nursing care
plan that also takes the patient’s cultural background
into consideration.
Culture Care Diversity- the changeable differences in
meanings, patterns, values, lifeways
or symbols of care within concepts
that are related in supporting human
care.

Culture Care Universality- the common, general

definitions of care with its patterns,
values, symbols and is observed
among many cultures and reflects
assistive ways to help people
 3 types of Nursing Action (identified three nursing decisions
and actions that achieve culturally friendly care for the patient.)

1. Cultural Care Preservation or Maintenance-

retention of relevant care values unique to
culture

2. Cultural Care Accommodation or Negotiation-

adapting culture with professional care
providers.

3. Cultural Care Repatterning or Restructuring –

changing life-ways while still respecting
culture for a healthier outcome.
Generic (Folk or Lay)
Care Systems
Generic (folk or lay)
care systems are
culturally learned and
transmitted, indigenous
(or traditional), folk
(home-based)
knowledge and skills
used to provide
assistive, supportive,
enabling, or facilitative
acts toward or for
another individual,
group, or instituti on