ABDELLAH 21 NURSING PROBLEMS
INTRODUCTION
(March 13, 1919 – February 24, 2017) Abdellah was the
first nurse and woman to serve as the Deputy Surgeon
General of the United States. Preceding her
appointment, she served in active duty during the
Korean War, where she earned a distinguished ranking
equivalent to a Navy Rear Admiral, making her the
highest ranked woman and nurse in the Federal Nursing
Services at the time. In addition to these achievements,
Abdellah led the formation of the Institute of Nursing
Research at the , and was the founder and first dean of
the Graduate School of Nursing at the Uniformed
ServiUniversity of the Health Sciences A few of
Abdellah's more passionate interests in public health
included the importance of long-term care planning for
elderly patients; the need to strengthen nursing school
infrastructure; and the necessity of patient-centered
approaches in nursing. In 2000 Abdellah was inducted
into the National Women's Hall of Fame. During her
acceptance speech, Abdellah made the following quote:
"We cannot wait for the world to change . Those of us
with intelligence, purpose, and vision must take the lead
and change the world . “I promise never to rest until my
work has been completed”
10 STEPS TO IDENTIFY THE CLIENT’S
PROBLEM
Learn to know the patient
Sort out relevant and significant data
Make generalizations about available data in
relation to similar nursing problems presented
by other patients
Identify the therapeutic plan
Test generalizations with the patient and make
additional generalizations
Validate the patient’s conclusions about his
nursing problems
Continue to observe and evaluate the patient
over a period of time to identify any attitudes
and clues affecting his behavior
Explore the patient’s and family’s reaction to
the therapeutic plan and involve them in the
plan
Identify how the nurses feels about the
patient’s nursing problems
Discuss and develop a comprehensive nursing
care plan
11 NURSING SKILLS
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
Therapeutic use of the self
Nursing procedure
21 NURSING PROBLEMS
To maintain good hygiene and physical comfort
To promote optimal activity: exercise, rest and
sleep
To promote safety through the prevention of
accidents, injury, or other trauma and through
the prevention of the spread of infection
To maintain good body mechanics and prevent
and correct deformity
To facilitate the maintenance of a supply of
oxygen to all body cells
To facilitate the maintenance of nutrition of all
body cells
To facilitate the maintenance of elimination
To facilitate the maintenance of fluid and
electrolyte balance
To recognize the physiological responses of the
body to disease conditions
To facilitate the maintenance of regulatory
mechanisms and functions
To facilitate the maintenance of sensory
function.
To identify and accept positive and negative
expressions, feelings, and reactions
To identify and accept the interrelatedness of
emotions and organic illness
To facilitate the maintenance of effective verbal
and non verbal communication
To promote the development of productive
interpersonal relationships
To facilitate progress toward achievement of
personal spiritual goals
To create and / or maintain a therapeutic
environment
To facilitate awareness of self as an
individual with varying physical , emotional, and
developmental needs
To accept the optimum possible goals in the
light of limitations, physical and emotional
To use community resource as an aid in
resolving problema arising from illness
To understand the role of social problems as
influencing factors in the case of illness
NURSING
Nursing is a helping profession.
Nursing care is doing something to or for the
person or providing information to the person
with the goals of meeting needs, increasing or
restoring self-help ability, or alleviating
impairment.
Nursing is broadly grouped into the 21 problem
areas to guide care and promote use of nursing
judgment.
Nursing to be comprehensive service.
PERSON
Abdellah describes people as having
physical, emotional, and sociological needs.
Patient is described as the only justification
for the existence of nursing.
Individuals (and families) are the recipients
of nursing
Health, or achieving of it, is the purpose of
nursing services.
HEALTH
In Patient–Centered Approaches to Nursing,
Abdellah describes health as a state mutually
exclusive of illness.
Although Abdellah does not give a definition of
health, she speaks to “total health needs” and “a
healthy state of mind and body” in her
description of nursing as a comprehensive
service
ENVIRONMENT
Society is included in “planning for optimum
health on local, state, national, and international
levels”. However, as she further delineated her
ideas, the focus of nursing service is clearly the
individual.
The environment is the home or community
from which patient comes.
USE OF 21 PROBLEMS IN THE NURSING
PROCESS
ASSESSMENT PHASE
Nursing problems provide guidelines for the
collection of data.
NURSING DIAGNOSIS
The results of data collection would determine
the client’s specific overt or covert problems.
PLANNING PHASE
The statements of nursing problems most closely
resemble goal statements. Once the problem has
been diagnosed, the nursing goals have been
established.
IMPLEMENTATION
Using the goals as the framework, a plan is
developed and appropriate nursing interventions
are determined.
EVALUATION
The most appropriate evaluation would be the
nurse progress or lack of progress toward the
achievement of the stated goals.
CONCLUSION
Abdellah ‘s typology of 21 nursing problems is a
conceptual model mainly concerned with patient’s needs
and the role of nurses in problem identification using a
problem analysis approach.According to the model,
patients are described as having physical, emotional, and
sociological needs. People are also the only justification
for the existence of nursing. That is, without people,
nursing would not be a profession since they are the
recipients of nursing.Patient-centered approaches to
nursing health are described as a state mutually exclusive
of illness. Abdellah does not provide a definition of health
but speaks to “total health needs” and “a healthy state of
mind and body” in her description of nursing.However,
Abdellah rather conceptualized nurses’ actions in nursing
care which is contrary to her aim of formulating a clear
categorization of patient’s problems as health needs.
Nurses roles were defined to alleviate the problems
assessed through the proposed problem-solving
approach.As a whole, the theory is intended to guide care
not just in the hospital setting, but can also be applied to
community nursing, as well. The model has interrelated
concepts of health and nursing problems, as well as
problem-solving, which is an activity inherently logical in
nature.
