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FAY ABDELLAH

PATIENT-CENTERED APPROACHES TO NURSING

"Nursing is based 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."

Biography

Born on March 13, 11 New !ork ity.

the #rst nurse o$cer to earn the ranking of a two%star rear admiral. &he was

the #rst nurse and the #rst woman to serve as a 'eputy &urgeon (eneral.

)er 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.

)er publications include Better Nursing are *hrough Nursing

+esearch and Patient-Centered Approaches to Nursing.

&he was inducted into the National omen-s )all of ame in /000.

bdellah2s Maor oncepts

1. Nursing

helping profession

comprehensive service to meet patient2s needs

4ncreases or restores self%help ability

5ses /1 problems to guide nursing care

/. )ealth

*he purpose of nursing services.

she speaks of 6total health needs7 and 6a healthy state of mind and body.7

8bdellah et al., 190:

3. ;erson

nvironment

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'id not discuss much

4ncludes room, home, and community

Societyis included in 6planning for optimum health on local, state, and

international levels.7

10 &teps to 4dentify ;atient2s ;roblems

1. ?earn to know the patient

/. &ort out relevant and signi#cant data

3. Make generali@ations about available data in relation to similar nursing problems

presented by other patients

=. 4dentify the therapeutic plan

A. *est generali@ations with the patient and make additional generali@ations

9. alidate the patient-s conclusions about his nursing problems

C. ontinue to observe and evaluate the patient over a period of time to identify

any attitudes and clues aDecting his behavior

E. >Fplore the patient-s and family-s reaction to the therapeutic plan and involve

them in the plan

. 4dentify how the nurses feel about the patient-s nursing problems

10. 'iscuss and develop a comprehensive nursing care plan

11 Nursing &kills

1.

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. direction of work of others

10. therapeutic use of the self

11. nursing procedure

/1 Nursing ;roblems

1. *o maintain good hygiene and physical comfort.

/. *o promote optimal activityG eFercise, rest, and sleep.

3. *o promote safety through the prevention of accidents, inury, or other

trauma and through the prevention of the spread of infection.

=. *o maintain good body mechanics and prevent and correct deformities.

A. *o facilitate the maintenance of a supply of oFygen to all body cells.

9. *o facilitate the maintenance of nutrition of all body cells.

C. *o facilitate the maintenance of elimination.

E. *o facilitate the maintenance of Huid and electrolyte balance.

. *o recogni@e the physiological responses of the body to disease conditions I

pathological, physiological, and compensatory.

10. *o facilitate the maintenance of regulatory mechanisms and functions.

11. *o facilitate the maintenance of sensory functions.

1/. *o identify and accept positive and negative eFpressions, feelings, and

reactions.

13. *o identify and accept the interrelatedness of emotions and organic illness.

1=. *o facilitate the maintenance of eDective verbal and nonverbal communication.

1A. *o promote the development of productive interpersonal relationships.

19. *o facilitate progress toward achievement of personal spiritual goals.

1C. *o create andJor maintain a therapeutic environment.

1E. *o facilitate awareness of self as an individual with varying physical, emotional,

and developmental needs.

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1. *o accept the optimum possible goals in the light of limitations, physical and

emotional.

/0. *o use community resources as an aid in resolving problems arising from illness.

/1. *o understand the role of social problems as inHuencing factors in the case ofillness.

eaknesses

?ittle emphasis on what the client is to achieve was given in terms of client

care.

bdellah2s framework is inconsistent with the concept of holism.

&trengths

s a logical and simple statement, bdellah2s problem%solving approach caneasily be used by practitioners to guide various activities within their nursing

practice.

*he problem%solving approach is readily generali@able to client with speci#c

health needs and speci#c nursing problems.

'orothy Kohnson

Behavioral &ystems Model

Background

11 Born in &avannah (eorgia

1=/ B&N anderbilt 5niversity &chool of Nursing

1=E M;) )arvard 5niversity

;rofessional >Fperience

Mostly involved teaching

1=3 I 1== staD nurse at

hatham% &avannah )ealth ouncil

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1= I 1CE 4nstructor and assistant professor in pediatric nursing at

anderbilt 5niversity &chool of Nursing

;rofessor of nursing at 5niversity of alifornia in ?

1E0 published the B.&. model

>arly proponent of nursing as a science and an art

B& model based on Nightingale2s belief

;urpose of &ystems *heory

Nurse creates balance between client and environment to achieve an optimal level

of functioning.

Kohnson2s C &ubsystems

Attache!t% goal attainment% form relationships and social bonds

Aggre""i#e% protect oneself to respond to threats

Depe!$e!cy I attention, recognition, physical assistance

I!ge"tio!% intake of nutrients to obtain knowledge

E%ii!atio!% eliminate waste and to eFpress feelings

Se&'a%% to procreate, to have seFual relationships, to develop gender based

identity

Achie#ee!t% mastery or control of some aspect of the environment

&ystem is out of balance whenL

1. insu$ciency does not get enough of something

/. discrepancy not optimally working

3. incompatibility subsystems conHict

=. dominance one subsystem is always used