APPLICATION OF NURSING THEORIES

INNURSING PROCESS

I. Lydia E. Hall’sI. Lydia E. Hall’sCore, Care and Cure ModelCore, Care and Cure Model

Hall’s three aspects of nursing

Concept:Concept: Care should be the primary focus and that nurses Care should be the primary focus and that nurses

were the most qualified to provide the type of care were the most qualified to provide the type of care that would enable patients to achieve their that would enable patients to achieve their maximum potential.maximum potential.

The focus of nursing is the provision of intimate The focus of nursing is the provision of intimate bodily care and the nurse must know how to bodily care and the nurse must know how to modify the care depending on the pathology and modify the care depending on the pathology and treatment while considering the patient’s unique treatment while considering the patient’s unique needs and personality.needs and personality.

Nursing as having three aspects, like care, Nursing as having three aspects, like care, core and cure.core and cure.

The individual, as unique, capable of The individual, as unique, capable of growth and learning and requiring a total growth and learning and requiring a total person approach.person approach.

Environment to be conducive for the Environment to be conducive for the patient’s self development.patient’s self development.

The major purpose of care is to achieve an The major purpose of care is to achieve an inter-personal relationship with the individual inter-personal relationship with the individual that will facilitate the development of core that will facilitate the development of core (i.e., the development of self-identity and self-(i.e., the development of self-identity and self-direction by the patient.direction by the patient.

ApplicationApplicationThis theory will be applicable in This theory will be applicable in

assessment, planning and implementation of the assessment, planning and implementation of the patient care.patient care.

Three interlocking circles, presenting Three interlocking circles, presenting a particular aspect of nursing like care, core and a particular aspect of nursing like care, core and cure.cure.

So, the patient whoever comes to So, the patient whoever comes to hospital will be considered as a Body, person and hospital will be considered as a Body, person and disease. The nurse who is providing care to the disease. The nurse who is providing care to the patient should meet all his bodily care like patient should meet all his bodily care like bathing, eating, elimination and dressing thereby bathing, eating, elimination and dressing thereby meeting his comfort.meeting his comfort.

During care, the nurse should During care, the nurse should develop an interpersonal relationship and develop an interpersonal relationship and consider the patient as a person to provide him consider the patient as a person to provide him a way to express his feelings and emotions to a way to express his feelings and emotions to gain self-identity.gain self-identity.

After developing an interpersonal After developing an interpersonal relationship, the nurse should see patient and relationship, the nurse should see patient and family through medical care and consider him family through medical care and consider him as a diseased person and act an advocate to as a diseased person and act an advocate to cure his condition.cure his condition.

II.II.BETTY NEUMAN SYSTEMS BETTY NEUMAN SYSTEMS MODELMODEL

(CONCEPTUAL MODEL)(CONCEPTUAL MODEL)

Concept:Concept: Major concepts identified in the model are;Major concepts identified in the model are;

ClientClient VariablesVariables EnvironmentEnvironment StressorsStressors Wellness &Wellness & Nursing InterventionsNursing Interventions

ClientsClients are viewed as wholes whose parts are viewed as wholes whose parts are in dynamic interaction.are in dynamic interaction.

VariablesVariables are those which simultaneously are those which simultaneously

affecting the client system. They are, affecting the client system. They are, Physiological, psychological, socio-cultural, Physiological, psychological, socio-cultural, developmental and spiritual.developmental and spiritual.

EnvironmentEnvironment is defined as being all the is defined as being all the internal and external factors that surround internal and external factors that surround and interact with person and client. There are and interact with person and client. There are three relevant environments: Internal, three relevant environments: Internal, External and Created.External and Created.

StressorsStressors (intrapersonal, interpersonal, (intrapersonal, interpersonal, extra personal) are significant to the concept extra personal) are significant to the concept of environment and are described as of environment and are described as environmental forces that interact with and environmental forces that interact with and potentially alter system stability.potentially alter system stability.

WellnessWellness is a condition where all the is a condition where all the subsystems are in balance and harmony with subsystems are in balance and harmony with the whole of the client and is balanced on the the whole of the client and is balanced on the actual or potential effort that environment actual or potential effort that environment stressors have on the energy level of the stressors have on the energy level of the system.system.

Nursing interventions are describedNursing interventions are described by by using the term prevention. There are three using the term prevention. There are three types of prevention: Primary, Secondary, and types of prevention: Primary, Secondary, and Tertiary.Tertiary.

Model:Model:The Neuman Systems ModelThe Neuman Systems Model

((Conceptual Model)Conceptual Model)

ApplicationApplication

This conceptual model will be applicable This conceptual model will be applicable for:for:

Assessment of the client systemAssessment of the client system Utilization of the nursing process (Planning)Utilization of the nursing process (Planning) Implementation of preventive interventionsImplementation of preventive interventions

Application of Betty Neuman’s Systems Model Application of Betty Neuman’s Systems Model for the Patient with Diabetes Mellitusfor the Patient with Diabetes Mellitus

III. HILDEGARD E. PEPLAUIII. HILDEGARD E. PEPLAUTHEORY OF INTERPERSONAL THEORY OF INTERPERSONAL

RELATIONSRELATIONSConcept:Concept: The four phases of the nurse-patient relationship The four phases of the nurse-patient relationship

are; Orientation, Identification, Exploitation and are; Orientation, Identification, Exploitation and Resolution.Resolution.

Ori

en

tati

on

Iden

tifi

cati

on

Exp

loit

ati

on

Resolu

tion

On admission

During intensive treatment period

Convalescence and Rehabilitation

Discharge

Overlapping phases in Nurse-patient relationships

She proposed and described six nursing roles like: She proposed and described six nursing roles like: Stranger, Resource person, Teacher, Leader, Stranger, Resource person, Teacher, Leader, Surrogate, and Counselor.Surrogate, and Counselor.

Factors influencing the blending of the nurse-patient relationship

HILDEGARD E. PEPLAU THEORY OF INTERPERSONAL

RELATIONS

ApplicationApplication

This theory will be applicable inThis theory will be applicable in AssessmentAssessment PlanningPlanning Implementation andImplementation and Evaluation of patient careEvaluation of patient care

Also, allows nursing to move away Also, allows nursing to move away from “doing to “to” doing with” clients.from “doing to “to” doing with” clients.

Application: PEPLAU’S FRAMEWORK FOR AN ANXIETY PATIENT

IV. FAYE GLENN ABDELLAHIV. FAYE GLENN ABDELLAHTWENTY-ONE NURSING TWENTY-ONE NURSING

PROBLEMSPROBLEMS

Concept:Concept: HealthHealth Nursing Problems andNursing Problems and Problem SolvingProblem Solving

HealthHealth may be defined as the dynamic may be defined as the dynamic pattern of functioning whereby there is a pattern of functioning whereby there is a continued interaction with external and continued interaction with external and internal forces that result in the optimal use internal forces that result in the optimal use of the wellness.of the wellness.

Nursing Problems:Nursing Problems: The client’s health The client’s health needs can be viewed as problems which may needs can be viewed as problems which may be overt as an apparent condition, or covert be overt as an apparent condition, or covert as a hidden or concealed one.as a hidden or concealed one.

Problem-solvingProblem-solving process involves, process involves, identifying the problem, selecting pertinent identifying the problem, selecting pertinent data, formulating hypothesis, testing data, formulating hypothesis, testing hypothesis through the collection of data hypothesis through the collection of data and revising the hypothesis when necessary and revising the hypothesis when necessary on the basis of conclusion obtained from the on the basis of conclusion obtained from the data.data.

Nursing Centered

Client centered

Disease centered

The focus of care pendulum

Abdellah’s Twenty-one Nursing Abdellah’s Twenty-one Nursing problemsproblems

It can be classified under four areas like, It can be classified under four areas like,

i.i. Physiological needsPhysiological needs

ii.ii. Safety needsSafety needs

iii.iii. Belonging and love needsBelonging and love needs

iv.iv. Esteem needsEsteem needs

I. Physiological needs includeI. Physiological needs include To maintain good hygiene and physical comfort.To maintain good hygiene and physical comfort. To promote optimal activity: exercise, rest, and To promote optimal activity: exercise, rest, and

sleep.sleep. To maintain good body mechanics, prevent and To maintain good body mechanics, prevent and

correct deformities.correct deformities. To facilitate the maintenance of:To facilitate the maintenance of:

- a supply of oxygen to all the body cells,- a supply of oxygen to all the body cells,

- nutrition of all body cells.- nutrition of all body cells.

- elimination,- elimination,

- fluid and electrolyte balance- fluid and electrolyte balance

II. Safety needs includeII. Safety needs include

To promote safety through the prevention of To promote safety through the prevention of accidents, injury, or other trauma and accidents, injury, or other trauma and through the prevention of spread of through the prevention of spread of infection.infection.

To facilitate the maintenance of sensory To facilitate the maintenance of sensory function.function.

III. Belonging and love needs III. Belonging and love needs includeinclude

To facilitate the maintenance of effective To facilitate the maintenance of effective verbal and non-verbal communication.verbal and non-verbal communication.

To promote the development of productive To promote the development of productive inter-personal relationships.inter-personal relationships.

To facilitate progress towards achievement To facilitate progress towards achievement of personal spiritual goals.of personal spiritual goals.

IV. Esteem needs includeIV. Esteem needs include

To recognize the physiological response To recognize the physiological response of the body to disease conditions – of the body to disease conditions – pathological, physiological, and pathological, physiological, and compensatory.compensatory.

To identify and accept positive and To identify and accept positive and negative expressions, feelings and negative expressions, feelings and reactions, the interrelatedness of reactions, the interrelatedness of emotions and organic illness.emotions and organic illness.

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

To facilitate awareness of self as an individual To facilitate awareness of self as an individual with varying physical, emotional and with varying physical, emotional and developmental needs.developmental needs.

To accept the optimum possible goals in the To accept the optimum possible goals in the light of limitations, physical and emotionallight of limitations, physical and emotional

To use community resource as an aid in To use community resource as an aid in resolving problems arising from illness.resolving problems arising from illness.

To understand the role of social problems as To understand the role of social problems as influential factors in the case of illness.influential factors in the case of illness.

ApplicationApplication

Physiological needs and

Esteem Needs

Assessment includesAssessment includes

This theory is mainly applicable for This theory is mainly applicable for assessment and identification of nursing problems assessment and identification of nursing problems with nurse-centered orientation.with nurse-centered orientation.

For e.g. If we take patient withFor e.g. If we take patient with Severe crushing chest painSevere crushing chest pain Shortness of breathShortness of breath Tachycardia andTachycardia and Profuse diaphoresisProfuse diaphoresis

The patient’s physiological needs includeThe patient’s physiological needs include

Hygiene and physical comfortHygiene and physical comfort Exercise, rest and sleepExercise, rest and sleep Maintenance of good body mechanics thereby Maintenance of good body mechanics thereby

deformity will be preventeddeformity will be prevented Oxygen supply to be administeredOxygen supply to be administered Nutrition to be metNutrition to be met Elimination needs to be taken careElimination needs to be taken care Fluid and electrolyte balance to be maintainedFluid and electrolyte balance to be maintained

The patient’s Esteem needs includeThe patient’s Esteem needs includeThe nurse should;The nurse should;

Recognize the abnormal signs and Recognize the abnormal signs and symptoms of heart problemsymptoms of heart problem

Identify his emotional status towards Identify his emotional status towards disease conditiondisease condition

Provide therapeutic environmentProvide therapeutic environment Facilitate self-awarenessFacilitate self-awareness

Make him to understand the optimum way of Make him to understand the optimum way of living and achieving goalsliving and achieving goals

Advice him about availability of community Advice him about availability of community resources to resolve complicationsresources to resolve complications

Make him to understand the social factors Make him to understand the social factors which will influence his disease conditionwhich will influence his disease condition

Thank You !!!Thank You !!!