Nursing Theories and Models: A Comprehensive Guide
1. Nurse Metaparadigm Factors
Person
The recipient of nursing care, encompassing physical, spiritual, psychological, and sociocultural aspects. This includes individuals, families, or communities.
Environment
All internal and external conditions, circumstances, and influences affecting the person.
Health
The degree of wellness or illness experienced by the individual.
Nursing
The activities, characteristics, and attributes of the individual providing nursing care.
2. Match of Models and Theories
Theories and Models of Development
Highlight progress and maturation, aiming to maximize personal growth.
Systems Theories and Models
Consider people as open systems, emphasizing the whole as greater than the sum of its parts.
Theories and Models of Interaction
Focus on relationships between people, with goals achieved through mutual interaction.
3. Characteristics of a Theory
Definition: A general principle of scientific value that guides practice and explains observed facts.
Features:
- Logical, relatively simple, and generalized.
- Composed of concepts and propositions.
- Links concepts together.
- Provides a basis for testable hypotheses.
- Consistent with other theories, laws, and principles.
- Describes, explains, predicts, or achieves desired results.
- Guides and improves nursing practice.
4. Florence Nightingale’s Environmental Theory
Foundation: The environment and its influence on life and development.
Basis: The interplay of a healthy environment with nursing.
Objective: Help patients maintain vitality and meet basic needs by controlling the environment.
Components of a Healthy Environment:
- Adequate ventilation
- Adequate lighting
- Sufficient heat
- Control of effluents
- Noise control
5. Types of Environments
Physical Environment
Physical elements like ventilation, temperature, hygiene, light, noise, and waste disposal. It affects all other aspects of the environment and influences the psychological environment.
Psychological Environment
Affected by the physical environment and involves activities that keep the mind active. Therapeutic communication is crucial.
Social Environment
Involves data collection and disease prevention. Includes physical environment components and the community surrounding the patient.
6. Virginia Henderson’s Postulates
- Individuals have 14 basic needs.
- Individuals desire and strive for independence.
- Unmet needs hinder wholeness and independence.
7. Virginia Henderson’s Nursing Intervention
Intervention Center
Areas of dependency related to knowledge, strength, and will.
Modes of Intervention
Aim to increase, complete, reinforce, or replace strength, knowledge, or will, but not replace the patient’s will entirely.
8. Dorothea Orem’s Self-Care Theory
Self-Care
Activities individuals initiate and perform to maintain their own lives, health, and well-being.
Self-care ability depends on factors like age, development, health status, experience, resources, interests, and motivations.
9. Universal Self-Care Requirements
Common to all humans and related to maintaining functioning and promoting health. Examples include air, water, food, elimination, activity/rest, social interaction, safety, and normal development.
10. Therapeutic Self-Care Demand
- Determine why the patient needs therapeutic self-care.
- Establish a nursing system and care plan.
- Perform and monitor nursing actions and patient changes.
11. Dorothea Orem’s Nursing Care Systems
Fully Compensatory System
For patients incapable of self-care. The nurse performs all care, compensates for the patient’s inability, and provides support and protection.
Partially Compensatory System
The nurse and patient share responsibility for care. The nurse compensates for limitations and assists as needed.
Supportive-Educative System
The nurse guides and educates the patient to perform self-care independently.
12. Problem-Solving
Identifying, interpreting, analyzing, and selecting actions to solve nursing problems. Similar to the nursing process, it involves problem identification, data selection, hypothesizing, testing, and revision.
13. Faye Abdellah’s Theoretical Statements
- Nursing problems and treatments are the principles of practice and the body of nursing knowledge.
- Correct problem identification influences the selection of appropriate solutions.
- The core of nursing problems is patient-centered.
14. Hildegard Peplau’s Nursing Roles
- Stranger: Providing courteous and respectful care at the beginning of the nurse-patient relationship.
- Resource Person: Providing information and answering questions about health and problems.
- Teacher: Providing instruction and facilitating learning through experience.
- Leader: Helping the patient fulfill responsibilities through active participation.
- Surrogate: Helping the patient understand their dependence, interdependence, and independence.
- Counselor: Helping the patient understand and integrate experiences into their lives.
15. Self-Care Deficit
Occurs when individuals cannot care for themselves due to health problems. Nurses address this deficit through therapeutic self-care demand.
16. Ernestine Wiedenbach’s Human Nature
- Every human has unique potential and should be encouraged to use their resources.
- Humans strive for self-determination and independence.
- Self-awareness and self-acceptance are essential for integrity and self-esteem.
- Individuals should make decisions based on the best approach.
17. The Art of Caring in the Clinical Setting
Central Purpose
The overall goal of nursing care, based on the nurse’s personal philosophy and code of conduct.
Prescriptions
The care plan specifying actions to fulfill the central purpose. Actions can be voluntary or involuntary.
Realities
The physical, psychological, emotional, and spiritual factors involved in the nursing situation, including the agent (nurse), recipient (patient), goal, means, and structure.
18. Sister Callista Roy’s Adaptation Model
System
A set of interrelated elements with a defined objective. Individuals, families, or groups are open systems that process stimuli through coping mechanisms and adaptation.
19. Lydia Hall’s Theory Concepts
Three interconnected circles representing aspects of nursing:
- Person (Core): Focuses on the patient and therapeutic use of self.
- Body (Care): Focuses on physical care and patient education.
- Disease (Cure): Focuses on pathological processes and patient advocacy.
20. Martha Rogers’ Basis of Nursing
- Humanitarian science and art.
- Focuses on health promotion, disease prevention, and rehabilitation.
- Considers the whole person, group, and environment.
21. Martha Rogers’ Unitary Human Beings
Promote harmonious interaction with the environment, strengthen awareness and integrity, and achieve maximum health potential. Humans are unified wholes in constant exchange with the environment, characterized by patterns, organization, sentience, and thought.
22. Principles of Homeodynamics
Resonance: Continuous wave changes between human and environmental fields.
Helicy: Continuous, innovative evolution of human and environmental fields.
Integrality: Ongoing mutual interaction between human and environmental fields. Nurses help individuals achieve balance and development.
23. Martha Rogers’ Theoretical Statements
- Humans are unified wholes with characteristics greater than the sum of their parts.
- Humans and the environment continuously exchange matter and energy.
- Life processes evolve irreversibly and unidirectionally.
- Humans are characterized by abstraction, imagination, language, thought, feelings, and emotions.
24. Jean Watson’s Carative Factors
- Humanistic-altruistic system of values.
- Instillation of faith and hope.
- Cultivation of sensitivity to self and others.
- Development of a helping-trust relationship.
- Promotion and acceptance of feelings.
- Use of the scientific problem-solving method.
- Promotion of interpersonal teaching-learning.
- Provision of a supportive, protective environment.
- Assistance with human needs.
- Allowance for existential-phenomenological forces.
25. Madeleine Leininger’s Fundamentals
- Culture: Values, beliefs, norms, and lifestyles guiding thoughts, decisions, and actions.
- Care: Behaviors that facilitate or improve a person’s situation.
- Cultural Care: Culturally specific values, beliefs, and expressions of care.
- Worldview: A person or group’s perspective on the world, encompassing social structure and environmental context.
- Health Systems: Culturally specific care practices used in homes or communities.
28. Assessment Steps
- Data Collection: Gathering information to determine health status and establish a care plan.
- Data Validation: Ensuring information is accurate and complete.
- Data Organization: Grouping information into categories for clearer understanding.
- Data Clustering: Grouping data according to human needs (physiological, safety, love/belonging, esteem, self-actualization).
- Communication and Recording: Reporting and documenting assessment findings.
29. Standards for Data Collection
- Reviewing patient history (optional for experienced nurses).
- Interviewing and observing the patient.
- Considering additional information sources.
30. Data Collection Steps
Interview
- Prepare and organize.
- Ensure privacy and focus.
- Introduce yourself and explain the purpose.
- Listen attentively and observe body language.
- Ask open-ended questions.
- Use therapeutic communication techniques.
- Summarize concerns and offer support.
Physical Assessment
- Inspection
- Auscultation
- Palpation
- Percussion
31. Planning Targets
- Setting priorities
- Establishing assessment criteria
- Determining nursing orders
- Recording the care plan
32. Nursing Process Stages
- Assessment: Gathering data.
- Diagnosis: Analyzing data and identifying problems.
- Planning: Setting goals and developing an action plan.
- Implementation: Putting the plan into action.
- Evaluation: Assessing the plan’s effectiveness and making changes.
33. Delegation
Transferring responsibility for an activity while maintaining accountability. Key points include delegating the right task to the right person in the right situation, using proper communication, and assessing competence.
34. Objectives of Care Plans
- Promote communication among caregivers.
- Direct care and documentation.
- Create a record for evaluation, research, and legal purposes.
- Provide documentation for cost determination.
35. Advantages of Standardized Care Plans
- Reduce routine documentation.
- Instruct staff on necessary actions.
- Provide a methodology for assessment and implementation.
- Ensure quality care.
36. Ida Jean Orlando’s Theory Elements
- Role of Professional Nursing: Helping patients meet their needs through direct or indirect actions.
- Patient Behavior: The starting point of the nursing process, reflecting the patient’s needs.
- Immediate Reaction of Nursing: The nurse’s perception, thought, and feeling in response to the patient’s behavior.
- Nursing Process Discipline: Communicating with patients and evaluating responses.
- Improvement: Striving for growth and progress.
37. Virginia Henderson’s Nursing Functions
- Helping individuals or patients.
- Serving as a health team member.
- Acting independently while supporting the physician’s plan.
- Possessing knowledge of biology and sociology.
- Evaluating basic human needs.
40. Hildegard Peplau’s Nurse-Patient Relationship Phases
- Orientation: Identifying problems and seeking professional help.
- Identification: Understanding the situation and relating to those who can help.
- Exploitation: Utilizing nursing services and care.
- Resolution: Achieving independence and setting new goals.
42. Benefits of the Nursing Process
- For Patients: Participation in self-care, continuity of care, improved quality of care.
- For Nurses: Expertise development, job satisfaction, professional growth.
43. Madeleine Leininger’s Theory Elements
See section 25 for details.
44. Individualized vs. Standardized Care Plans
Individualized: Tailored to specific patient needs.
Standardized: Pre-developed plans for common situations.
45. Data Sources for Assessment
- Patient
- Family/significant others
- Nursing records
- Medical records
- Consultations
- Diagnostic tests
- Literature
48. Problem-Solving Method Stages
- Identify the problem and gather information.
- Analyze information and identify resources.
- Develop a plan of action.
- Implement the plan and observe the response.
- Evaluate the plan’s effectiveness.
49. Nursing Process Characteristics
- Purposeful
- Systematic
- Dynamic
- Interactive
- Flexible
- Theoretically based
50. Diagnostic Reasoning
- Analyze data.
- Create a list of suspected problems.
- Exclude similar diagnoses.
- Choose specific diagnostic labels.
- Identify strengths and areas for improvement.
51. Principles of Diagnostic Reasoning
- Familiarity with diagnoses
- Open-mindedness
- Evidence-based formulation
- Awareness of limitations
52. Steps to Diagnose Health Problems
- Identify the main problem.
- Complete the assessment.
- Determine normal and altered functioning.
- Consider each suspected problem.
- Include and exclude problems.
- Name the problems.
- Determine causes.
53. Advantages of Nursing Diagnoses
- Identify patient problems.
- Focus care on nursing aspects.
- Improve quality of care.
- Use a common vocabulary.
- Facilitate teamwork.
- Emphasize prevention.
- Evaluate workload.
- Assess quality.
- Make nursing more scientific.
- Emphasize the nursing role.
54. Causes of Diagnostic Errors
- Incomplete data
- Overthinking
- Personal biases
- General diagnoses
- Rushing
55. Risks of Diagnostic Errors
- Exacerbating problems
- Missing essential interventions
- Allowing problems to progress
- Wasting time
- Legal liability
56. Determining Nursing Orders
Writing clear instructions for implementing the care plan, including what to observe, do, teach, and document.
57. Identifying Nursing Interventions
Activities to assess health status, prevent or manage problems, assist with daily living, and promote health and independence.
58. Implementation
- Receiving shift report
- Setting priorities
- Assessing and reassessing
- Implementing interventions
- Documenting
- Giving shift report
59. Documentation
Communicating care to other professionals, identifying response patterns, providing a basis for evaluation and research, creating a legal document, and validating service payment.
60. Evaluation of a Care Plan
- Determining goal achievement
- Identifying influencing factors
- Deciding to maintain, modify, or terminate the plan
61. Completing the Care Plan
- Determining home care needs.
- Providing oral and written instructions.
- Ensuring understanding.
- Discharging the patient.
62. Determining Goal Achievement
- Assess current health status.
- List planning phase goals.
- Compare current abilities to goals.
- Determine the extent of goal achievement.
- Record findings.
63. Virginia Henderson’s Nurse-Patient Relationship Levels
- Substitute: Providing care when the patient lacks strength, will, or knowledge.
- Helper: Assisting the patient in regaining independence.
- Partner: Monitoring, educating, and supporting the patient in self-care.