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8/12/2019 TTheoretical Foundation of Nursing Practice
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THEORETICALFOUNDATION
NURSING PRACTICE
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THEORY:A theory is a set of concepts, definition relationship and assumproject a systematic view of phenomena.
A Nursing theory is a conceptualization of some aspect of nursincommunicated for the purpose of describing, explaining, predict
and / or prescribing nursing care(Maleis 1997)
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Components of Theory:
Concepts Definitions
Assumptions(or)
Propositions
Phenomenon
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Concepts:
A theory consists of interrelational concepts. Conce
are mental formulation of an object (or) event that come from
individual perceptual experience ( Alligood & marriner tomey
2002)
Definitions:
The definitions with in the descriptions of a theoryconvey the general meaning of the concepts in a manner tha
fits the theory.
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Assumptions :
Assumptions are statements that describe
concepts (or) connect two concepts that are factual.
Phenomenon:
A fact (or) situation that is observed to exist(or) happen.
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NURSINGS PARADIGM:
According to Fawcett, a conceptual model consists of
concepts which are generally considered central to the discipline of Nurs
This serves as an organizing frame work around which conceptual
development proceeded
Person
Health
Environment/Situation
Nursing
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Person:
Refers to the recipient of nursing care, including individual clie
families and the community.
Health:
It is defined in different way by the client, the clinical setting a
healthcare profession.
Environment / Situation:It includes all possible conditions affec
client and the setting is which health care needs occur.
Nursing:
It is the diagnosis and treatment of human responses to actual
potential health problem (ANA 1995)
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Classification of theories in Nursing
According to range/scope/abstractness, theories are classified
1) Meta theories
2) Grand theories
3) Middle range theories4) Practice theories
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1) Meta theories
Meta theories describe the philosophical basis of t
discipline. Focuses on broad issues such as the processes of
generating knowledge & theory development.
2) Grand theories
This describes the comprehensive conceptual
framework. There are the most complex and broadest in
scope. They attempt to explain broad area within a disciplin
and may incorporate numerous other theories.
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3) Middle range theories
Middle range theory lies between the nursing models a
circumscribed, concrete ideas (practice theories)
Middle range theories are substantively specific and enc
limited number of a real world.
4)Practice theories
Practice theories are also called micro theories, prescrip
theories (or) situation theories
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FAYE GLENN ABDELLAHS TYPOLO
OF NURSING PROBLEM
(Patientcentered approaches to Nursing)(Twenty one Nursing problems)
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Introduction:
Abdellah was motivated to develop her typology by a des
promote comprehensive, clientcentered nursing care.
She used the problemsolving approach
Her typology of nursing problem was first published in 196
centered approaches to nursing
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Concept of Abdellahs Theory
Abdellahs theories would state that nursing isuse of the problem solving approach based on the thre
concepts of health, nursing problems and problem solv
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Health
She defined health as the dynamic pattern of functioning
there is a continued interaction which internal and external force t
in the optional use of necessary resources that serve to minimize
vulnerabilities
Nursing Problems
It may be overt as an apparent condition or convert as a h
concealed one. Because convert problems can be emotional, Socio
interpersonal in nature, they are often missed (or) perceived incor
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Problem solving
Quality professional Nursing care requires that nurses
be able to identify & solve, overt & convert nursing problems.
This can be accomplished by problem solving approach. it
involves
Indentifying the data
Selecting pertinent data
Formulating Hypotheses
Testing Hypotheses through the collection of data
Revising Hypotheses
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Focus of care pendulum
Nursing Disease
Centered Centered
Client centered
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Abdullahs 21 Nursing problems
1)Adequate Hygiene & Physical comfort
2)Optimal activity : exercise, rest and sleep
3)Safety by preventing accidents , injury or other trauma and
the spread of infection.
4) Good body mechanics and prevention and correction of d
5) Adequate O2 supply to all body cells
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6) Nutrition for all body cells
7) Elimination
8) ) Fluid & electrolyte balance
9) Recognition of the bodys physiologic responses to disease
(pathological, physiological &compensatory)
10) Maintenance of Regulatory mechanisms &functions
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11) Sensory function
12) Identification and acceptance of (+)ve and (-)ve expression, feel
reactions
13) Identification & acceptance of the interrelatedness of emotions
illness
14) Effective verbal and nonverbal communications.
15) Productive IPR (interpersonal relationship)
16) Progress toward personal spiritual goals.
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17) A therapeutic environment
18) Awareness of oneself as an individual with varying physical, emo
developmental needs .
19)Acceptance of the optimum possible goals in light of physical an
limitations
20) Community resources as an aid in resolving problems arising fr
21) Understanding of social problems as influencing factors in illness
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Abdellahstypology and the four concepts of the nursing met
a) Person:1) It is described by Abdellah as one who has physical, e
(or) sociological need, helping a person with these need is nurs
justification.
2) He is the recipient of nursing care
3) Includes families as well as individuals4) He Is capable of learning and self-help to varying de
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b) Environment :
1) It is the least discussed concept of Abdellahstypolog
2) It include the atmosphere of a client room, home and
community
Abdullah also discuss a therapeutic environment but does not
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C) Health:
1)It is not specifically defined by Abdellah, but she refers to hea
healthy state of mind body, the clients continued health is the
nursing
2) It is viewed as a state that excludes illness
3)It can also described as a state in which the person has no un
and no anticipated actual impairment
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d) Nursing:
1)It is a helping profession
2) It is a comprehensive service that combines art and science
3) Does something to (or) for a client (or) provides information
meet the client needs, increases or restores self help ability or
as impairment
4) Uses the nursing process, a problem-solving approach
5)Can use the 21 nursing problems as a guide for nursing care
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* Limitations :
- Very strong Nursing centered orientation
- with this orientation appropriate uses might be the organizat
teaching content for nursing students, the evaluation of a stud
performance in the clinical area (or) both but in terms of clien
there is little emphasis on what the client is to achieve
- Abdellahsframe work is inconsistent with the concept of ho
.
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* Conclusion
Abdellastheory and frame work provide basis for dete
organizing nursing care. if all of the problem are investigated, t
would be likely to be thoroughly assessed.