Midterms TFN • Nurses fled their lives; soon there was

shortage of people to care for the sick

Historical Evolution of Nursing
• Hundreds of Hospitals closed; there was no
PERIOD OF INTUITIVE NURSING/MEDIEVAL provision for the sick, no one to care for the
PERIOD sick
• Nursing became the work of the least
Intuition
desirable of women – prostitutes,
Intuition is more than simply a "gut feeling," and it alcoholics, prisoners
is a process based on knowledge and care • Pastor Theodore Fliedner and his wife,
experience and has a place beside research-based Frederika established the Kaiserswerth
evidence. Institute for the training of Deaconesses
(the 1st formal training school for nurses) in
Intuitive Nursing
Germany.
• Nursing was “untaught” and instinctive. It • This was where Florence Nightingale
was performed of compassion for others, received her 3-month course of study in
out of the wish to help others. nursing.
• Nursing was a function that belonged to • During the late middle Ages (1000-1500)
women. It was viewed as a natural -the crowding and poor sanitation in the
nurturing job for women. She is expected to monasteries nurses went into the
take good care of the children, the sick and community. During this era hospitals were
the aged. built and the number of medical schools
• No caregiving training is evident. It was increases. Between 1500 and 1860 (A.D.)
based on experience and observation. -the Renaissance all affected nursing. As
• Primitive men believed that illness was nursing was not valued as an intellectual
caused by the invasion of the victim’s body endeavor it lost much of its economic
of evil spirits. They believed that the support and social status. The nursing
medicine man, Shaman or witch doctor had conditions were at their worst and have
the power to heal by using white magic, been called the dark period of nursing. New
hypnosis, charms, dances, incantation, hospitals had been built but quickly became
purgatives, massage, fire, water and herbs places of horror as unsanitary conditions
as a mean of driving illness from the victim. caused them to be a source of epidemics
• Trephining – drilling a hole in the skull with and disease.
a rock or stone without anesthesia was a • Crusades
last resort to drive evil spirits from the body • Military religious orders established
of the afflicted. hospitals staffed with men
• Knights of Lazarus was founded and
Contribution of Ancient Civilization
primarily for the nursing care of lepers in
• Asclepius – chief healer (a hero and a god of Jerusalem after the Christians had
medicine in ancient Greek mythology) conquered the city.
• Hygeia - daughter of Asclepius; goddess of • Rise of Secular Orders
health and was admired by some as the • Religious taboos and social restrictions
embodiment/qualities of the nurse influenced nursing at the time of the
Religious Nursing orders
• Hippocrates – father of medicine
• Hospitals were poorly ventilated and the
PERIOD OF APPRENTICE NURSING/MIDDLE AGES beds were filthy
• There was overcrowding of patients: 3 or 4
• Nursing care was performed without any
patients regardless of diagnosis or whether
formal education and by people who were
dead or alive, may have shared one bed.
directed by more experienced nurses (on
• Practice of environmental sanitation and
the job training). This kind of nursing was
asepsis were non-existent
developed by religious orders of the
• Older nuns prayed with and took good care
Christian Church.
of the sick, while younger nuns washed
• Care was done by crusaders, prisoners,
soiled linens, usually in the rivers.
religious orders
• St. Catherine of Siena. The first “Lady with a
• Nursing went down to the lowest level
Lamp”. She was a hospital nurse,
• Wrath/anger of Protestantism confiscated
prophetess, researcher and a reformer of
properties of hospitals and schools
society and the church.
connected with Roman Catholicism.
• In 16th century, hospitals were established
for the care of the sick where hospitals
 were gloomy, cheerless, airless and • Nightingale focus vision of nursing
unsanitary. People entered hospitals only Nightingale system was more on developing
under compulsion or as a last resort the profession within hospitals. Nurses
should be taught in hospitals associated
Important Personages
with medical schools and that the
1. St. Clare – founder of the second order of curriculum should include both theory and
St. Francis of Assisi; took vows of poverty, practice.
obedience service and chastity; gave • It was the 1st school of nursing that
nursing care to the sick and the afflicted. provided both theory-based knowledge and
2. St. Elizabeth of Hungary – known as the clinical skill building.
“Patroness of Nurses” she was the daughter • Nursing evolved as an art and science
of the Hungarian king. – She lived her life • Formal nursing education and nursing
frugally despite her wealth. She used all her service begun
wealth to make the lives of the poor happy
Facts about Florence Nightingale
and useful.
3. St. Catherine of Siena – the first “Lady with • Mother of modern nursing. Lady with the
a lamp” she was the 25th child of humble Lamp because of her achievements in
Italian parents. improving the standards for the care of war
casualties in the Crimean war.
Reformers in this Era
• Born May 12, 1800 in Florence, Italy
• John Howard – a prison reformer helped • Raised in England in an atmosphere of
improve the living conditions in prisons and culture and affluence
gave prisoners renewed hope. • Not contended with the social custom
• Mother Mary Aikenhand – established the imposed upon her as a Victorian Lady, she
Irish Sisters of Charity to bring back into developed her self-appointed goal: To
nursing the dedication of the early Christian change the profile of Nursing
era. • She compiled notes of her visits to hospitals
and her observations of the sanitary
• Pastor Theodor Fliedner and Frederike
facilities, social problems of the places she
Munster Fliedner – established the institute
visited.
for the Training of Deaconesses at
• Noted the need for preventive medicine
Kaiserwerth Germany (1836), the first
and good nursing
organized training school for nurses.
• Advocated for care of those afflicted with
PERIOD OF EDUCATED NURSING/NIGHTINGALE diseases caused by lack of hygienic practices
ERA 19TH-20TH CENTURY • At age 31, she entered the Deaconesses
School at Kaiserswerth in spite of her
(From June 15, 1869 when Florence Nightingale
family’s resistance to her ambitions. She
School of Nursing was opened until World War II)
became a nurse over the objections of
The development of nursing during this period was society and her family.
strongly influenced by: • Worked as a superintendent for
Gentlewomen Hospital, a charity hospital
1. trends resulting from wars – Crimean, civil
for ill governesses.
war
• Disapproved the restrictions on admission
2. arousal of social consciousness
of patients and considered this unchristian
3. Increased educational opportunities offered
and incompatible with health care
to women.
• Upgraded the practice of nursing and made
• Florence Nightingale was asked by Sir
nursing an honorable profession for
Sidney Herbert of the British War
women.
Department to recruit female nurses to
• Led nurses that took care of the wounded
provide care for the sick and injured in the
during the Crimean war
Crimean War.
• Put down her ideas in 2 published books:
• In 1860, The Nightingale Training School of
Notes on Nursing, What It Is and What It Is
Nurses opened at St. Thomas Hospital in
Not and Notes on Hospitals.
London.
• She revolutionized the public’s perception
• The school served as a model for other
of nursing (not the image of a doctor’s
training schools. Its graduates traveled to
handmaiden) and the method for educating
other countries to manage hospitals and
nurses.
institute nurse-training programs.
Crimean War (1854-1856)
The inadequacy of care given to soldiers led to a nurses. Medical specialties also arose at that time
public outcry in Great Britain. The role Florence to meet the needs of hospitalized clients.
Nightingale played in addressing this problem is
well known. She was asked by Sir Sidney Herbert of
the British War Department to recruit a contingent Emancipation of Women
of female nurses to provide care to the sick and
In 1860, The Nightingale Training School of Nurses
injured in Crimea.
opened at St. Thomas Hospital in London.
Nightingale and her nurses transformed the
• The school served as a model for other
military hospitals by setting up sanitation practices,
training schools. Its graduates traveled to
such as hand washing and washing clothing
other countries to manage hospitals and
regularly.
institute nurse-training programs.
Harriet Tubman and Sojourner Truth • Nightingale focus vision of nursing
Nightingale system was more on developing
• provided care and safety to slaves fleeing to
the profession within hospitals. Nurses
the North on the Underground Railroad.
should be taught in hospitals associated
Mother Biekeryke and Clara Barton with medical schools and that the
curriculum should include both theory and
• searched the battlefields and gave care to
practice.
injured and dying soldiers.
• It was the 1st school of nursing that
Authors Walt Whitman and Louisa May Alcott provided both theory-based knowledge and
clinical skill building.
• volunteered as nurses to give care to
injured soldiers in military hospitals. Arousal of Social Consciousness

Dorothea Dix • Nursing evolved as an art and science

• Formal nursing education and nursing
• became the Union’s superintendent of
service begun
female nurses responsible for recruiting
nurses and supervising the nursing care of Popularization of the Philosophy of the
all women nurses working in the army Nightingale System
hospitals.
1. Importance of nursing education
World War I (1914-1918) 2. Hospital affiliation
3. Nurses teaching students
Arrival of World War I resulted in American, British,
4. Health teaching as critical responsibility
and French women rushing to volunteer their
5. Enforced written physician orders
nursing services. These nurses endured harsh
6. Expansion in no. of schools to North
environments and treated injuries not seen before.
America
A monument entitled “The Spirit of Nursing” stands 7. Specialization developed
in Arlington National Cemetery. It honors the
PERIOD OF CONTEMPORARY NURSING/20TH
nurses who served in the U.S. armed services in
CENTURY
World War I, many of whom are buried which is
also called the “Nurses Section”. • Health is perceived as a fundamental
human right
Progress in health care occurred during World War
• Nursing involvement in community health
I, particularly in the field of surgery. For example,
• Expanded roles of nurses was developed
advancements were made in the use of anesthetic
• WHO was established by the United Nations
agents, infection control, blood typing, and
prosthetics. Education and Technology Represent the Largest
Differences Between Nursing’s Past and Present
World War II
Development of Baccalaureate and Advance
Casualties created an acute shortage of caregivers,
Degree Programs
and the Cadet Nurse Corps was established in
response to a marked shortage of nurses. • Training of Nurses in diploma program
• College Degree or Nursing Specialist
Auxiliary health care workers became prominent.
Certification
“Practical” nurses, aides, and technicians provided • Certification Programs emerged
much of the actual nursing care under the • Licensure of nurses started
instruction and supervision of better-prepared • Specialization of Hospital and diagnosis
Scientific and technological development as well  Investigates Nursing problems to
as social changes marks this period. improve nursing care and to refine
and expand nursing knowledge
• Technological advances – disposable
supplies and equipment
 Nurse Administrator
• Aerospace Nursing was developed
 Manages client care, including the
• Use of atomic energies for medical
delivery of nursing services
diagnosis, treatment
 May be a head nurse, supervisor,
• Computers were utilized-data collection,
director of nursing services
teaching, diagnosis, inventory, payrolls,
 Responsible for budgeting, staffing,
record keeping, and billing.
planning programs
• Use of sophisticated equipment for
diagnosis and therapy  Nurse Educator
• Advances in technology and medicine  Responsible for classroom and
created the need for more educated nurses. clinical teaching
 Nurse Entrepreneur
Types of Education Programs in Nursing  Manages a health-related business
Licensed Practical (VOCATIONAL) Nursing  Forensic Nurse
Programs  Provides Specialized Care for
individuals who are victims and/ or
Registered Nursing Programs perpetrators of trauma
a. Diploma Programs (Apprentice Nursing) HISTORY OF NURSING IN THE PHILIPPINES
b. Associate Degree Programs (Contemporary
Nursing) Early Care of the Sick
c. Baccalaureate Degree Programs  Superstitious beliefs and practices
d. Graduate Nursing Programs  People suffering from diseases (bewitched)
- Master’s Degree Programs  Nunos
- Doctoral Programs
 Midwives
Continuing Education  Mabuting hilot
 Herbicheros
 In-service education Program
 Witchcraft
Career Roles in Nursing  Mangkukulam

 Nurse Practitioner Health Care During Spanish Regime

 Areas:
 Simple nutrition
- Adult-gerontology
 Wound care
- Family
 Taking care of an ill member of the family
- Neonatal
 Intervention of babaylan and albularyo
- Pediatric
 Male nurses (practicante or enfermero)
- Women’s Health/Gender Related
- Psychiatric-Mental Health Timeline
 Employed in Health Care Agencies
1890
 Clinical Nurse Specialist
 Expert in a specialized area of  Nursing during Philippine Revolution
practice  Philippine Red Cross
 Provides direct client care, educates
1909
others, consults, conducts research,
and manages care.  3 females graduated as “qualified medical-
 Nurse Anesthetist surgical nurses"
 Carries out pre-operative visits and
1919
assessments
 Administers general anesthetics for  Act 208 or the "First Nurses Law" was
surgery under physician’s enacted regulating the practice of the
supervision nursing profession in the Philippines
 Nurse Midwife
1920
 Has a completed a program in
Midwifery  First Board Examination for Nurses was
 Gives prenatal and postnatal care conducted by the Board of Examiners
 Nurse Researcher
  Theoretical Exam was held at the UP - provided nursing care to Filipino soldiers
Amphitheater of the College of Medicine during revolution
and Surgery Practical Exam at the PGH - president of PH Red cross branch in
Library Batangas

1921 Melchora Aquino

 Filipino/Philippine Nurses Association - Nursed the wounded Filipino soldiers

o Founder: Anastacia Giron - Tupas 1st - Gave shelter and food
President: Rosario Delgado
Capitan Salome
1953
- a revolutionary leader in Nueva Ecija
 Republic Act 877 "Nursing Practice Law" - nursing care to the wounded when not in
combat
Early Hospitals during the Spanish Regime
Agueda Kahabagan
 Hospital Real de Manila (1577)
 San Lazaro Hospital (1578) - revolutionary leader in Laguna
 Hospital de Indios (1586) - nursing services to her troops
 Hospital de Aguas Santas (1590) Trinidad Tecson
 San Juan de Dios Hospital (1596)
- "Mother of Biak-na-Bato"
HOSPITAL AND NURSING SCHOOLS - stayed in the hospital at Biak-na-Bato to
 First training for filipino nursing students care for wounded soldiers
(1970) INTRODUCTION TO NURSING THEORY
 Studied many of the same subjects as
nursing students in Idea - any thought or product of mental activity;
 the US but it was believed that the can be developed into concepts.
curriculum isn't that or never a mirror Concepts - group of ideas; building blocks of
image production of the American nursing theory; may vary from one person to another.
curriculum.
 Simple transfer of knowledge from 3 types:
American nurses to filipino nurses • Empirical concept- can easily be observed
 Studied subjects that were more relevant to eg. Color of urine, texture of hair,
their patients smoothness of skin, etc.
HOSPITAL SCHOOL OF NURSING'S FORMAL • Inferential concept- needs instruments to
TRAINING (1901-1911) measure things eg. Thermometer, Blood
pressure with sphygmomanometer and
 American missionary doctors’ nurses stethoscope.
 Insufficient manpower • Abstract concept- non-observable non-
 Training of Filipino nurses that would be quantifiable concepts eg. love, care, death,
catering to the hospitals that Americas spirituality
established in the 20th century
Theory - “theria”: vision; futuristic; a beholding
People spectacle or speculation.
Josephine Bracken Kerlinger (1979)- a set of interrelated constructs
(variables/concepts) and propositions, with the
- Wife of Dr. Jose Rizal
purpose of explaining natural phenomena.
- Field Hospital in Tejeros
- Constructs are concepts invented to suit a
Rosa Sevilla de Alvero
special purpose. eg freudian’s id, ego,
- converted house into quarters for filo superego
soldiers during ph-american war (1899) - Propositions are statements expressing
significant relationship among or between
Dona Hilaria de Aguinaldo
concepts.
- wife of Emilio Aguinaldo - Phenomena are facts or can be a situation
- organized Filipino red cross under the that is observed to exist or happen, and can
inspiration of Mabini be studied. eg. communication, holistic care
and management
Dona Maria Agoncillo de Aguinaldo
- Hypothesis: There is no significant
- second wife of Emilio Aguinaldo difference/relationship with nurses in public
 and private hospitals in terms of their (foundation to independent), organizational
holistic care and management to their chart, process (IPO- input, process, output),
patients. (null) polarity and continuity.
Chin and Kramer (1999) - defines theory as a
creative and rigorous structure of ideas that project
Knowledge Skills Quality Nursing Care
a tentative, purposeful, and systematic view of
phenomena. Assumptions- are self-evident truths; underlying
givens that are presumed to be true.
SUMMARY - theory is made up of groups or set of
concepts, interrelated, with rigorous step by step Theoretical Assumption- basic givens or accepted
processes, and with the purpose of explaining and truths that are fundamental to theoretical
predicting a phenomenon. reasoning.
- the purpose of theory is to describe (report Types of Assumption:
or narrate), explain (clarify by describing),
• Explicit: easy to be recognized; given
predict (foresee or anticipate), control
• Implicit: not stated in theory; implied
(command) the world and its phenomena.
Forms of Assumption:
Theories are not laws
• Factual Assumptions- based on facts,
- Theories are tentative and temporary
knowable through experience and easily
meaning they change and can develop
recognized.
through time.
• Value Assumptions- imply what is right,
- Laws are factual; they remain to be true in
good, or ought to be. Gains and benefits.
all places and in all time.
NURSING THEORY
Model: idea/s  concepts  theory
NURSING THEORY
Metaparadigm (major concepts)
▪ A conceptualization of some aspect of reality
- -core content of a disciple, stated in the (invented or discovered) that pertains to nursing.
most global or abstract terms
▪ are organized bodies of knowledge to define
- -summarize the intellectual and social
what nursing is, what nurses do, and why do they
missions of the discipline
do it.
- -broad concepts that define a discipline or
profession
Nursing theories, together with Research and
Metaparadigm of Nursing Practice, is one of the foundations in the
development of nursing as a unique discipline.
- person: recipient of nursing care;
individuals; patients/clients; Just like any other theories, the main purpose of
family/community nursing theories is DESCRIBING, EXPLAINING,
- Environment: internal and external aspects PREDICTING and PRESCRIBING NURSING CARE.
that influence the person; internal,
• As nurses/nursing students develop their
intrapersonal communication; external,
theories in nursing, they became more equipped
weather changes
in caring for patients with more care needs like
- health: holistic level of wellness; status of
those in critical setting.
we wellbeing of a person
- nursing: autonomous and collaborative care USES OF NURSING THEORY:
of individuals of all ages, families, groups
and communities, sick or well in all settings. 1. TO DIFFERENTIATE THE FOCUS OF NURSING
FROM OTHER PROFESSIONS.
Models - are representations of interaction among
and between concepts showing patters; also
2. TO STRUCTURE PROFESSIONAL NURSING INTO
termed as paradigm or framework.
2 types: PRACTICE, EDUCATION AND RESEARCH.
• Verbal Model- narrative description of
3. TO HELP BUILD A COMMON NURSING
interrelationships.
TERMINOLOGY TO USE IN COMMUNICATING
• Schematic Model- use schema, symbols,
WITH
holand physical visualizations; diagram,
OTHER HEALTH CARE PROFESSIONALS.
drawing, graph, or picture eg. discrete-
overlapping common areas, pyramid
4. TO ENHANCE AUTONOMY OF NURSING THRU condition, patient population or age group,
DEFINING ITS OWN INDEPENDENT FUNCTIONS. location or area of practice, action of nurse &
intervention.
COMPONENTS OF NURSING THEORY:
▪ Complete nursing theory contains the following:
Example: Roy initially developed a conceptual
(Barnum, 1994)
model which is “Adaptation Model”, she later
a. CONTEXT: The environment in which the
developed on her theory of a person as an
nursing act takes
adaptive system which is considered to be a grand
place. -For example, in an emergency
theory.
environment,
community setting, etc. ✓ For some authors, theory is termed as Middle
Range theory while Middle Range is termed as
b. CONTENT: The subject of the theory -For micro range theory
example: Care of
dying, stress adaptation, rehabilitation, etc. ✓ As the knowledge structure tends to decrease,
c. PROCESS: The method the nurse uses in the theory became more specific and concept
applying the theory – became more testable.
For example: Nursing process, use of
interpersonal
relationship, counselling, etc.
TYPES OF NURSING THEORY
According to Knowledge Structure…
1. METAPARADIGM: Most abstract level of
knowledge; describe the major concept of the
discipline. In Nursing, these pertains to Person,
Health, Nursing and Environment
2. PHILOSOPHY: Specifies the definition of the
metaparadigm concepts. Theories maybe TABLE 1:
formalized from these philosophies. EXAMPLES OF THEORY BASED ON THE
LEVEL OF KNOWLEDGE STRUCTURE
Example of a philosophy is the Environmental ACCORDING TO ORIENTATION OR FOCUS OF THE
Theory of Florence Nightingale. She focused only THEORY:
ON one of the major concepts in Nursing which is
the Environment and her theory was focused and 1. CLIENT CENTERED: THIS THEORY FOCUSED ON
revolved to it. THE PATIENT OR THE RECIPIENT OF NURSING
3. CONCEPTUAL MODELS: provide different view CARE. EXAMPLE IS THE THEORY OF VIRGINIA
of the discipline. HENDERSON FOCUSING ON THE 14 BASIC NEEDS
OF A PERSON.
In Nursing, example of this theory is the work of
Dorothy Johnson which view Nursing in the lens of 2. CLIENT-NURSE DYNAMICS: THIS THEORY
Behavioral System. Another example if the work FOCUSED ON THE INTERACTION OF THE NURSE
or Sister Calista Roy which view Nursing in terms AND THE PATIENT. EXAMPLE IS THE THEORY OF
of Adaptation Model. Another example is the HILDEGARD PEPLAU ON INTERPERSONAL
work of Evelyn Adam, that describe the RELATIONS IN NURSING; AND ALSO, THE WORK OF
Conceptual Model of Nursing. JEAN WATSON ON CARATIVE FACTORS.

4. GRAND THEORY: this is as broad as conceptual 3. CLIENT-NURSE ENVIRONMENT: THIS THEORY

model and they not only provide view or FOCUS ON HOW A NURSE INTERRELATE WITH THE
perspective but also proposed testable truths. PATIENT ON A SPECIFIC SCENARIO OR
5. THEORY: - this maybe broad but limited to the ENVIRONMENT. EXAMPLE IS LEININGER’S
aspects of nursing they addressed. TRANSCULTURAL NURSING WHEREIN THE NURSE
RELATE WITH THE PATIENT BASED ON HIS
Example: Madeleine Leininger’s Theory which CULTURE.
focused on transcultural nursing; Ida Jean
CHARACTERISTICS OF A GOOD THEORY:
Orlando’s work FOCUSED on the nursing process.
6. MIDDLE RANGE THEORY: narrower focus than THEORIES SHOULD POSSESS CHARACTERISTICS SO
theory. It specifies things as situation or health AS TO MAKE IT MORE USABLE AND CONTRIBUTE
SIGNIFICANTLY TO A DISCIPLINE. ACCORDING TO
GEORGE (2014), A GOOD THEORY SHOULD: 2. GUIDES CURRICULAR DECISION MAKING.

1. THEORIES CAN INTERRELATE CONCEPTS IN SUCH C. THEORY TO RESEARCH:

A WAY AS TO CREATE A DIFFERENT WAY OF
LOOKING AT A PARTICULAR PHENOMENON. 1. OFFERS A FRAMEWORK FOR GENERATING
KNOWLEDGE AND NEW IDEAS.
2. THEORIES MUST BE LOGICAL IN NATURE
2. ASSISTS IN DISCOVERING KNOWLEDGE GAPS IN
3. THEORIES SHOULD BE RELATIVELY SIMPLE YET THE SPECIFIC FIELD OF STUDY.
GENERALIZABLE.
3. OFFERS SYSTEMATIC APPROACH TO IDENTIFY
4. THEORIES CAN BE THE BASES FOR HYPOTHESIS FOR STUDY, SELECT VARIABLES, INTERPRET
THAT CAN BE TESTED. FINDINGS AND VALIDATE NURSING
INTERVENTIONS.
5. THEORIES CONTRIBUTE TO AND ASSIST IN
INCREASING GENERAL BODY OF KNOWLEDGE
WITHIN THE DISCIPLINE THROUGH THE
RESEARCH IMPLEMENTED TO VALIDATE THEM.

6. THEORIES CAN BE UTILIZED BY THE

PRACTITIONER TO GUIDE AND IMPROVE THEIR
PRACTICE

7. THEORIES MUST BE CONSISTENT WITH OTHER

VALIDATED THEORIES, LAWS AND PRINCIPLES BUT
WILL LEAVE OPEN UNANSWERED QUESTIONS
THAT NEED TO BE INVESTIGATED.

RELATIONSHIP OF NURSING THEORY, PRACTICE,

EDUCATION AND RESEARCH:

A. THEORY TO PRACTICE:

1. ASSISTS NURSES TO DESCRIBE, EXPLAIN AND

PREDICT EVERYDAY PROFESSIONAL
EXPERIENCES.

2. SERVES TO GUIDE IN ASSESSMENT,

INTERVENTION AND EVALUATION OF NURSING
CARE.

3. IT VALIDATES, ENHANCES, AND IMPROVES

NURSING PRACTICE.

4. PROVIDES RATIONALE FOR COLLECTING

RELIABLE AND VALID DATA ABOUT THE HEALTH
STATUS OF THE PATIENT WHICH ARE ESSENTIAL
FOR EFFECTIVE DECISION MAKING AND
IMPLEMENTATION.

5. ENHANCES AUTONOMY (INDEPENDENCE AND

SELF-GOVERNANCE) OF NURSING THRU DEFINING
ITS OWN INDEPENDENT FUNCTIONS.

B. THEORY TO EDUCATION (ACADEME):

1. PROVIDES A GENERAL FOCUS FOR

CURRICULUM DESIGN.
 Presentation of Concepts, Relationships, Model,
and Nursing Metaparadigm:
• ENVIRONMENTAL THEORY
- It focuses on the alteration of the patient’s
environment in order to affect change in his
or her health.
- It is a Patient-care Theory.
NURSING THEORETICAL WORKS METAPARADIGM/MAJOR CONCEPTS:
A. ARTS AND SCIENCE OF HUMANISTIC NURSING ENVIRONMENT:

FLORENCE NIGHTINGALE - linked Health with the “Five

Environmental Factors” namely:
(ENVIRONMENTAL THEORY)
 Pure or Fresh Air,
 born on May 12, 1820, in Florence, Italy.  Pure Water,
 second daughter of William Edward  Efficient Drainage,
Nightingale and Frances Nightingale and  Cleanliness,
sister of Parthenope Nightingale Verney  Light.
 A social Reformer
 A Statistician - It also refers to the “Health of Houses”
 The Mother of Modern Nursing which is an underlying principle of putting
 The Lady with the Lamp in Crimean War the patient in condition which is best for
nature to act upon him/her.
 Belong to an upper-class family
 Refused the life of traditional women of METAPARADIGM/MAJOR CONCEPTS:
her time
INDIVIDUAL:
 Religious inspiration led her to devote her
life to serving others, both directly and as a - The One receiving the care, wherein he/she is a
reformer. multidimensional being, that includes biological,
 On February 17, 1837, she experienced one psychological, social, and spiritual component.
of several “calls from God,” She viewed her
- A Recipient with vital Reparative Process to deal
calling as reducing human suffering. Nursing
with disease and health but passive in terms of
seemed the suitable route to serve God and
influencing the environment or the nurse.
humankind.
 She traveled in Europe looking at hospitals HEALTH:
and in 1844, she enrolled as a nursing
-Not just the absence of disease. Health is not only
student at the Lutheran Hospital of Pastor
to be well, but to be able to use well every power
Fliedner in Kaiserswerth, Germany.
that we have.
 Nightingale died on August 13, 1910, at the
age of 90 in her home in London. -Health is maintained through the prevention of
 She is buried at St. Margaret’s Church, East disease via Environmental Health factors.
Wellow, near Embley Park.
NURSING:
 The Crimean monument in Waterloo Place,
London erected in 1915 was done in honor -as “the act of utilizing the environment of the
of the contribution Florence Nightingale patient to assist him/her in his/her recovery”
had made to the war and the health of the
-It is the provision of optimal conditions to enhance
army.
the person’s reparative processes and prevent the
LITERARY WORKS reparative process from being interrupted.

 “Notes on Nursing: What it Is, and what it is THEORETICAL ASSUMPTIONS:

Not” (1860) was one of these publications and
1. There is a belief that the nurturing/surrounding
was the first textbook specifically for use in the
environment, the body could repair itself.
teaching of nurses and translated into many
languages. 2. The poor environmental conditions are directly
 “Notes on Hospitals” (1859) related to the patient’s disease or ailment.
 “Notes on Nursing for the Laboring Classes”
3. Her general concepts about ventilation,
(1861)
cleanliness, quiet, warmth & diet remain integral
parts of nursing and health care today.
FLORENCE NIGHTINGALE’s ENVIRONMENTAL B. QUALITATIVE NURSING RESEARCH
MODEL:
“THE 10 CANONS OF ENVIRONMENT”
1. Ventilation- refers to the overall temperature of
the surrounding.
2. Noise- it could be good or bad noise. It refers to VIRGINIA HENDERSON
the avoidance of sudden and loud noises that (DEFINITION OF NURSING AND THE 14 BASIC
might affect the stability of the patient such as NEEDS)
when he/she is taking a rest.
 born on November 30, 1897
3. Air - it could either be polluted/unclean or clean.
 born in Kansas City, Missouri, in 1897
4. Nutrition- it refers to the diet and intake of a  fifth of the eight children of Lucy Minor
certain patient/individual that might affect his/her Abbot and Daniel B. Henderson.
body condition.  She enlisted in the Army School of Nursing
in Washington, D.C., where students were
5. Light- it could either be natural (sunlight) or
treated more like cadets.
unnatural.
 Her career as a nursing educator started in
6. Bedding- it refers to the condition of the bed 1924 at the Norfolk Protestant Hospital in
that the patient/individual is resided to. Virginia where she was the first and only
teacher in the nursing school.
7. Variety- it refers to the factors that could help
 She is a respected educator and researcher.
ease the patient’s boredom and depression.
 She published a book entitled the 'Nature
8. Health of Houses- this includes the Five of Nursing' where she gained the title "The
environmental factors namely Pure or Fresh Air, first lady of Nursing" or the "Florence
Pure Water, Efficient Drainage, Cleanliness, and Nightingale of the 20th century"
Light.
Literary Works:
9. Chattering Hopes- it refers to the
 The three editions of the Principles and
encouragement and motivation that the nurse
Practice of Nursing (1955),
could give to the patient to soothe his
 Basic Principles of Nursing Care (1960) and
psychological, mental, and emotional condition
revised in 1972.
that would aid in his/her fast recovery.
 The Nature of Nursing (1966)
10. Cleanliness- it refers to the sanitation of the
Presentation of Concepts, Relationships, Model,
environment as well as the hygiene of the nurse
and Nursing Metaparadigm:
that is giving the interventions.
- She formulated a definition of a unique
APPLICATION OF THE ENVIRONMENTAL THEORY:
function of nursing.
1. NURSING PRACTICE:
- This definition was a major stepping stone
A. PROVISION OF SANITATION in the emergence of Nursing as a discipline
separate from medicine.
B. KEEPING THE PATIENT WARM
NURSING:
C. MAINTAINING A NOISE-FREE
ENVIRONMENT “The unique function of the nurse is to assist the
individual, sick or well, in the performance of those
D. ATTENDING TO PATIENT’S DIET
activities contributing to health or its recovery (or
(ASSESSMENT OF INTAKE, TIMELINESS OF
to a peaceful death) that he would perform
THE FOOD AND ITS EFFECT ON THE
unaided if he had necessary strength, will or
PATIENT)
knowledge. And to do this in such a way as to help
E. REGULAR HOSPITAL WARD/UNIT VS. ICU him gain independence as rapidly as possible.”
VS. COMMUNITY
PERSON/HUMAN:
F. PSYCHIATRIC WARD MANAGEMENT
- Considered as biological, psychological,
G. TELEMEDICINE DURING COVID-19 sociological, spiritual components.
PANDEMIC
- Have basic needs reflected on 14 components.
2. NURSING RESEARCH:
- Mind & body are inseparable and must maintain
A. QUANTITATIVE NURSING RESEARCH physiological and emotional balance.
- The individual and family should be viewed as a 10. Communicate with others in expressing
unit. emotions, needs, fears, or opinions -
(PSYCHOLOGICAL)
- No two individuals are alike, each is unique.
11. Worship according to one’s faith - (SPIRITUAL)
12. Work in such a way that there is a sense of
ENVIRONMENT:
accomplishment - (SOCIOLOGICAL)
- Henderson stated that everything that is outside
13. Play or participate in various forms of
of the patient but is connected to the patient is
recreation -(SOCIOLOGICAL)
considered the environment and the 14 basic
human needs should be connected to the 14. Learn, discover, or satisfy the curiosity that
environment. leads to normal development and health and use
the available health facilities - (PSYCHOLOGICAL)
- Pertains to family but rarely to community.
APPLICATION OF THE 14 BASIC NEEDS OF PATIENT
- She strongly believes that the society expects
IN:
nurse’s services of acting for patients who are
disabled and function independently. 1. NURSING PRACTICE
HEALTH: 2. NURSING RESEARCH
-Ability of the individual to function independently. FAYE GLENN ABDELLAH
-Needs the necessary strength, will or knowledge (21 NURSING PROBLEMS)
to achieve or maintain health
- The first nurse and the first woman who served as
MAJOR ASSUMPTIONS: Deputy Surgeon General.
1. Nurse’s care for patients until they can care for - She developed the “21 Nursing Problem Theory,”
themselves once again. which shifted the nursing focus from disease-
2. Patients desire to return to health. centered to patient-centered, and began to include
families and elderly in nursing care.
3. Nurses are willing to serve and that “Nurses will
devote themselves to the patient day and night. - Abdellah’s theory is a Patient—Center Approach
to Nursing, which emphasizes the science of
4. Henderson also believes that the “mind and nursing and has elicited changes throughout
body are inseparable and are interrelated. nursing.
THE 14 BASIC NEEDS: - She formulated it as an instrument for Nursing
Virginia Henderson enumerated 14 components education, to serve as guide care in hospital
that will make up the basic nursing care institutions and Community Health Nursing.
(fundamental needs), which are as follows: Presentation of Concepts, Relationships, Model,
PHYSIOLOGIC: and Nursing Metaparadigm:

1. Breath Normally 3 COMPONENTS OF F.G. ABDELLAH’S THEORY:

2. Eat & drink adequately 1. METAPARADIGM

3. Eliminate Body wastes 2. THE NURSING PROBLEMS

4. Move & maintain desirable position 3. PROBLEM SOLVING APPROACH/PROCESS

5. Sleep & Rest “THE 21 NURSING PROBLEMS”:

6. Select suitable clothes NURSING PROBLEMS:

7. Maintain body temperature within normal range - Conditions faced by the patient and/or family
by adjusting clothing and modifying the which the nurse can assist him or them to meet
environment through the performance of her professional
function.
8. Keep the body clean & well groomed & protect
the integument - OVERT & COVERT NURSING PROBLEMS

9. Avoid dangers in the environment & avoid OVERT – “Objective cues” (Largely Physical) (ex.
injuring others. Wound on the skin, yellowish sclerae, blood in the
urine, watery stools)
COVERT – “Subjective cues” (Largely Subjective) - The changing nursing education; continuing
(ex. Body weakness (malaise), numbness of hands, education for professional nurses.
dizziness, nausea, headache)
KEY EMPHASIS:
PATIENT’S PROBLEMS DETERMINE APPROPRIATE
NURSING CARE FAYE GLENN ABDELLAH’S
TYPOLOGY OF

METAPARADIGM/MAJOR CONCEPTS:
THE 21 NURSING PROBLEMS:
PERSON (Individuals and families):
A. BASIC TO ALL PATIENTS (PREVENTIVE CARE
- pertains to the recipients of Nursing. They are
NEEDS):
people who have physical, emotional, and
sociological needs. Patient is described as the only 1. To maintain good hygiene and physical comfort.
justification for the existence of nursing.
2. To promote optimal activity: exercise, rest, sleep.
HEALTH:
3. To promote safety through prevention of
- as she described as a comprehensive service, is accident, injury, or other trauma and through
“total health needs” and “a healthy state of mind prevention of the spread of infection.
and body”. It is also a state mutually exclusive of
4. To maintain good body mechanics and prevent
illness
and correct deformity.
ENVIRONMENT AND SOCIETY:
B. PHYSIOLOGICAL (SUSTENAL CARE NEEDS):
- pertains to “planning for optimum health on local,
5. To facilitate the maintenance of a supply of
state, and international levels.” But Abdellah
oxygen to all body cells.
believes that the individual is the focus of Nursing
services. It is the home or community from which 6. To facilitate the maintenance of nutrition for all
patient comes from. body cells.
NURSING: 7. To facilitate the maintenance of elimination.
-is a helping profession. Nursing care is providing 8. To facilitate the maintenance of fluid and
information or doing something for/to the person electrolyte balance.
with the goals of meeting needs, increasing or
9. To recognize the physiologic responses of the
restoring self-help ability, or alleviating
body to disease conditions pathologic, physiologic,
impairment.
and compensatory.
- Grouped into 21 Nursing problems area to guide
10. To facilitate the maintenance of regulatory
care & promote use of Nursing judgement.
mechanisms and functions.
Presentation of Concepts, Relationships and
11. To facilitate the maintenance of sensory
Model: function.
PROBLEM SOLVING APPROACH: C. EMOTIONAL, INTERPERSONAL & SPIRITUAL
(REMEDIAL CARE NEEDS):
- step by step process; systematic way of dealing
with Nursing problems. 12. To identify and accept positive and negative
expressions, feelings, and reactions.
-The process of identifying Nursing problems
(interpreting, analyzing, and selecting appropriate 13. To identify and accept interrelatedness of
courses of action to solve these problems). emotions and organic illness.
THEORETICAL ASSUMPTIONS: 14. To facilitate the maintenance of effective verbal
and nonverbal communication.
According to Abdellah, her assumptions relate to
change and anticipated changes that affect nursing. 15. To promote the development of productive
interpersonal relationships.
-the need to appreciate the interconnectedness of
social enterprises and social problems. 16. To facilitate progress toward achievement and
personal spiritual goals.
-the impact of problems such as poverty, racism,
pollution, education, and so forth on health and 17. To create or maintain a therapeutic
health care delivery. environment.
18. To facilitate awareness of self as an individual
with varying physical, emotional, and
developmental needs.
D. SOCIOLOGICAL (RESTORATIVE CARE NEEDS):
19. To accept the optimum possible goals in the
light of limitations, physical and emotional.
20. To use community resources as an aid in LYDIA HALL
resolving problems that arise from illness. (CARE, CORE AND CURE)
21. To understand the role of social problems as THEORY – “THE 3 C’S OF LYDIA HALL”
influencing factors in the cause of illness.
- Lydia Eloise hall’s interest and research in
PROBLEM SOLVING APPROACH/PROCESS: the field of rehabilitation of chronically ill
(10 STEPS) patients brought her to develop her now-
famous care, cure, core theory.
1. Learn to know the patient. - She was always interested in rehabilitative
2. Sort out relevant and significant data. nursing and the role that the professional
nurse played in the patient’s recovery and
3. Make generalizations about available data in welfare.
relation to similar nursing problems presented by - She became involved in the establishment
other patients. of the Loeb center for nursing and
4. Identify the therapeutic plan. rehabilitation at the Montefiore medical
center (mmc) in the Bronx, New York.
5. Test generalizations with the patient and make - Lydia hall worked as the first director of the
additional generalizations. Loeb center for nursing. Her nursing
6. Validate the patient’s conclusions about his experience was in clinical nursing, nursing
nursing problems. education, research, and in a supervisory
role.
7. Continue to observe and evaluate the patient - In the 1960s, she authored 21 publications
over a period of time to identify any attitudes and and a bulk of articles regarding the loeb
clues affecting his or her behavior. center and her theories of long-term care
8. Explore the patient and his or her family’s and chronic disease control.
reactions to the therapeutic plan and involve them
THEORY OVERVIEW
in the plan.
9. Identify how the nurses feel about the patient’s  THEORY DEVELOPED IN LATE 1960’S
nursing problems.  NURSING CARE CAN BE DELIVERED ON
THREE INTERLOCKING LEVELS
10. Discuss and develop a comprehensive nursing
 CARE = HANDS ON BODILY CARE
care plan.
 CORE = USING SELF IN RELATIONSHIP TO
APPLICATION OF FAYE GLENN ABDELLAH’S PATIENT
 CURE = THE DISEASE APPLYING MEDICAL
THEORY:
KNOWLEDGE
1. NURSING PRACTICE:  PATIENT CARE FROM ONLY TRAINED
NURSES
A. NURSING PROCESS (ADPIE)
B. NURSING CARE PLAN (NCP) FINES NURSING AS CARE PERFORMED BY A
TRAINED PROFESSIONAL
2. NURSING RESEARCH:
A. QUANTITATIVE NURSING RESEARCH  CARE FOCUSED ON INDIVIDUALS, FAMILIES
AND COMMUNITIES
B. QUALITATIVE NURSING RESEARCH  CARE FOCUSED ON MAINTAINING OPTIMAL
HEALTH AND QUALITY LIFE FROM BIRTH TO
END OF LIFE
 CARE IS ONGOING MATRIX OF LEARNING
AND TEACHING
Presentation of Concepts, Relationships, Model,  The size of each circle constantly varies and
and Nursing Metaparadigm: depends on the state of the patient.

INDIVIDUAL:

 The source of energy and motivation for healing

is the individual care recipient. Hall emphasizes
the importance of the individual as unique,
capable of growth and learning, and requiring a
total person approach.

HEALTH:

 Health can be inferred to be a state of self-

awareness with a conscious selection of
behaviors that are optimal for that individual.
Hall stresses the need to help the person
explore the meaning of his or her behavior to The Care
identify and overcome problems through The CARE circle explains the role of nurses, and
developing self-identity and maturity. focused on performing that noble task of nurturing
the patients, meaning the component of this model
SOCIETY AND ENVIRONMENT: is the “motherly” care provided by nurses, which
may include provision of comfort measures,
 The concept of society or environment is dealt
provision of patient teaching activities and helping
with in relation to the individual. Hall is credited
the patient meet their needs where help is needed.
with developing the concept of Loeb Center
because she assumed that the hospital  Nurturing component of care
environment during treatment of acute illness  It is exclusive to nursing
creates a difficult psychological experience for  “Mothering”
the ill individual.  Provides teaching and learning activities
 Nurse’s goal is to “comfort” the patient
NURSING:  Patient may explore and share feelings with
nurse
 Nursing is identified as consisting of
participation in the care, core, and cure aspects The Core
of patient care. The CORE is the person or patient to whom nursing
care is directed and needed.
THEORETICAL ASSUMPTIONS:
The CORE has goals set by himself and not by any
The assumptions of Lydia Hall’s Care, Core, Cure other person.
Theory are as follows:
The CORE behaved according to his feelings and
1. The motivation and energy necessary for value system.
healing exist within the patient, rather than in  Patient care is based on social sciences
the healthcare team.  Therapeutic use of self
2. The three aspects of Nursing should not be  Helps patient learn their role is in the
viewed as functioning independently but as healing process
interrelated.  Patient is able to maintain who they are
3. The three aspects interact, and the circles  Patient able to develop a maturity level
representing them change size, depending on when nurse listens to them and acts as
the patient’s total course of progress. sounding board
 Patient able to make informed decisions
Subconcepts:
The Cure
 Lydia Hall’s theory has three (3)
- The CURE is the attention given to patients by the
Components which are represented by
medical professionals.
three independent but interconnected
circles. The three circles are: the CARE, the - Based on Pathological and Therapeutic Sciences.
CORE, and the CURE.
- Application of medical knowledge by nurses.
- Nurse assisting the doctor in performing tasks. 1. Theory of Self-care - describes the why and
(Nurse is the patient advocate at this area). how people care for themselves.
2. Theory of Self-care Deficit – describes and
- Medical-Surgical and Rehabilitative care
explains why people can be helped through
Nursing.
3. Theory of Nursing Systems – describes and
explains relationships that must be brought
about and maintained for Nursing to be
produced.
1. Theory of Self-care:
• This theory focuses on the practices that the
APPLICATION OF THE CARE, CORE, CURE THEORY individual initiate and perform on their own. It is
OF LYDIA HALL: based on the concepts of:
1. NURSING PRACTICE: A. Self-Care - The performance of activities that
a. Rehabilitation Nursing the individuals initiate and perform on their
b. Medical-Surgical Nursing own behalf to maintain life, health and well-
c. Intensive Care Unit Nursing being.
d. Discharge Planning B. Self-Care Agency - The ability of an individual to
e. Referral System perform self-care activities.

1. NURSING RESEARCH: 2 Agents:

a. QUANTITATIVE RESEARCH 1. Self-Care Agent - person who provide the

b. QUALITATIVE RESEARCH care. Affected by basic conditioning factors
such as age, gender, health state and
DOROTHEA OREM environmental factors.
2. Dependent Care Agent - person other than
- Dorothea Orem began her nursing career at the individual. (Parent or Guardian)
Providence Hospital School of Nursing in
Washington, DC, where she received a diploma C. Self-care Requisites:
of nursing in 1934. - actions directed towards provision of self-care.
- While in 1939, she received her BS in Nursing
Education from Catholic University of America 3 categories of Self-care requisites are:
(CUA). And in the same university, she received
1. Universal Self-care requisites
an MS in Nursing Education in 1946.
2. Developmental Self-care requisites
- Her early nursing experiences included
3. Health deviation Self-care requisites
operating room nursing, private nursing duty
(home and hospital), hospital staff nursing on 1. Universal Self-care requisites: associated with
pediatric and adult medical and surgical units, life processes and the maintenance of the
evening supervisor in the emergency room, and integrity of human structure and functioning.
biological science teaching.
• Common to all; activities of daily living (ADL).
- Dorothea Elizabeth Orem’s first published book
Identifies these requisites as:
was Nursing: Concepts of Practice published in
1971. In 2004, a reprint of the second edition - Maintenance of sufficient intake of air, water,
was produced and distributed by the food
International Orem Society for Nursing Science - Provision of care associated with elimination
and Scholarship (IOS). process
- Balance between activity and rest, between
Presentation of Concepts, Relationships, Model,
solitude and social interaction
and Nursing Metaparadigm:
- Prevention of hazards to human life well being
SELF-CARE DEFICIT NURSING THEORY: - Promotion of human functioning

• The general theory states that a self-care demand 2. Developmental Self-care requisites: associated
exists when the patient of family members are not with developmental processes/derived from a
able to provide care for him/herself and those self- condition or associated with an event.
care demands can be met by the nurse.
(Ex: – adjusting to a new job
The Self-care Deficit Theory is a general theory
– adjusting to body changes
composed of 3 (three) interrelated theories:
3. Health deviation Self-care requisites: required - Either the patient or the person may have a
in conditions of illness, injury, or disease. These major role in the performance of care
include: measures.
- Seeking & securing appropriate medical (Ex.: Nurse can bring a meal tray for the client who
assistance. can feed himself)
- Learning to live with effects of pathologic
C. Supportive – educative systems:
conditions.
- being aware of and attending to the effects and - the system that requires assistance in decision
results of pathologic conditions. making, behavior control and acquisition of
- Modifying self-concepts in accepting oneself as knowledge and skills.
being in a particular state of health and in - The patient is able to perform or can and
specific forms of health care. should learn to perform required measures of
externally or internally oriented therapeutic
D. Therapeutic Self-care demand:
Self-care but cannot do so without assistance.
- "totality of self-care actions to be performed
(Ex: The Nurse guides a mother how to breast feed
for some duration in order to meet self-care
her baby)
requisites by using valid methods and related
sets of operations and actions” METAPARADIGM/MAJOR CONCEPTS:
2. Theory of Self-care Deficit: is the focus of PERSON:
Dorothea Orem’s grand theory in Nursing.
- The recipient of nursing care who can function
• Specifies when Nursing is needed. biologically, symbolically and socially.
• Nursing is required when an adult (or in the - Has the capacity for self-knowledge and has
case of a dependent, the parent) is potential for learning and development.
incapable or limited in the provision of - Can learn to meet self-care requisites.
continuous effective self-care. - Individual, patient, self-care agent, dependent
self-care agent.
Dorothea Orem identifies 5 methods of helping or
methods of assistance: ENVIRONMENT:
1. Acting for or doing for another - Person and Environment are functional units in
2. Guiding and directing others which exchange is reciprocal and influence is
3. Providing physical and psychological mutual.
support - It has two dimensions: Environmental and
4. Providing and maintaining an environment Developmental
that supports personal development
Health:
5. Teaching another
- “being structurally and functionally whole or
3. Theory of Nursing Systems: Describes how the
sound”
patient’s Self-care needs will be met by the nurse,
- Includes promotion and maintenance of health,
the patient or both.
treatment of disease and prevention of
• Identifies 3 classifications of Nursing System to complications.
meet the Self-care requisites of the patient: - Not only a bodily state but also how one
functions in everyday living.
a. Wholly compensatory system
b. Partly compensatory system NURSING:
c. Supportive – educative system
Dorothea Orem viewed Nursing as a community
A. Wholly compensatory systems: service and an art.
- when the nurse is expected to accomplish all • Community Service:
the patient’s therapeutic self-care or
It is an interpersonal process that requires the
compensate for the patient’s inability to engage
social encounter of a nurse with a patient based on
in self-care or when the patient needs
the values of that community.
continuous guidance in self-care.
• Art:
(Ex.: Patient in PACU)
It is the ability to assist others in the design,
B. Partly compensatory systems:
provision, and management of self-care to improve
- when both the nurse and the patient engage in or to maintain human functioning at some level of
meeting self-care needs. effectiveness.
THEORETICAL ASSUMPTIONS: - Evelyn Adam received a B.Sc. degree in 1966 from
the University of Montreal and an M.N. degree
• Human beings require continuous,
from the University of California at Los Angeles in
deliberate inputs to themselves and to their
1971.
environments to remain alive and function
in accordance with natural human - At U.C.L.A. she met Dorothy Johnson, who she
endowments. feels has "definitely been the most important
• Mature human beings experience privations influence" on her professional life.
in the form limitations for action in care for
- In 1979 she published her first book Être
self and others involving making of life-
Infirmiere (3rd edition, 1991) and in 1980 wrote
sustaining and function-regulating inputs.
the English version of To Be a Nurse (2nd edition,
1991). Since then, her book has been translated
into Dutch (1981), Spanish (1982), Italian (1989),
and Portuguese (1993).
- Evelyn Adam has also written numerous articles
on conceptual models for nursing and has co-
authored several others. Professional journals
publishing her articles include Infirmière
Canadienne, Canadian Nurse, Journal of Advanced
Nursing, Nursing Papers: Perspectives in Nursing,
and Journal of Nursing Education.
Presentation of Concepts, Relationships, Model,
DOROTHEA OREM’S THEORY: CONCEPTUAL and Nursing Metaparadigm:
FRAMEWORK:
-Evelyn Adam's "Conceptual Model of Nursing"
Self-care deficit results when the Self-care agency is hypothesis focuses on the development of models
not adequate to meet the known Self-care demand and theories on the concept of Nursing, namely
Dorothy Johnson and Virginia Henderson's
APPLICATION OF THE SELF-CARE DEFICIT
theories.
THEORY:
-In Her Book, “To Be a Nurse”, Adam explains the
1. NURSING PRACTICE: essential elements of a conceptual model as
presented by Dorothy Johnson.
A. NURSING PROCESS (ADPIE)
B. PATIENT ADMITTED IN THE ICUs - She then develops Virginia Henderson's concepts
C. POST OPERATIVE PATIENT CARE & within the structure of a conceptual model.
MANAGEMENT
- Evelyn Adam’s “Conceptual Model of Nursing” has
D. PATIENT WITH CHRONIC HISTORY OF DISEASES
6 components – (Goal of the profession,
AND DISORDERS
Beneficiary, Role, Source of Difficulty, Intervention,
E. PSYCHIATRIC NURSING COUNSELLING
and Consequences).
F. HEALTH EDUCATION IN A COMMUNITY
SETTING 1. The goal of the profession - the end the
member of the profession strives to achieve.
THEORY:
2. Beneficiary - A person or a group of people
2. NURSING RESEARCH: who the professional directs their activities like
the client.
A. QUANTITATIVE NURSING RESEARCH 3. Role - This is the part that the professional
- “Awareness and Practices of Self-care among plays. It is the societal function of the
postpartum mothers based on The Dorothea professional.
Orem’s theory in Nursing” 4. Source of Difficulty - The probable origin of the
client's difficulty to which the professional is
B. QUALITATIVE NURSING RESEARCH prepared to cope.
- “The effects of Dorothea Orem’s Self-care Model 5. Intervention - The focus or center of the
to Patients with Alzheimer’s Disease” professional’s attention, the moment they
intervene with a client.
EVELYN ADAMS 6. Consequences - The results of the
professional’s effort to attain the ideal and
EVELYN ADAM (CONCEPTUAL MODEL OF
limited goal.
NURSING)
PERSON:
- defined as the beneficiaries, who are the Values:
individuals or groups of individuals to whom the
The beliefs and values "constitute the 'why' of the
professional directs their efforts.
model and are not subject to the criteria of truth."
- The person is portrayed as a complex whole, They must "reflect the value system of the larger
made up of 14 fundamental needs. Each need has society that the profession wishes to serve" and
biological, physiological, and psychosocial cultural "be shared by the members of the profession who
dimensions. wish to use the model."
When a need is not satisfied, the person is not APPLICATION OF THE CONCEPTUAL MODEL OF
complete, whole, or independent. The nurse's NURSING:
client may also be a family or a group.
1. NURSING PRACTICE:
ENVIRONMENT:
a. Nursing Process (ADPIE)
- The concept of environment is specifically b. Medical-Surgical Unit/Ward
addressed in only one of the fundamental needs. c. Emergency Room
However, the environment is implicit in all the d. Psychiatric Unit/Ward
fundamental needs because the sociocultural e. Community Setting
dimension is integral to each need.
2. NURSING RESEARCH:
- According to Evelyn Adam's Theory, in order to
a. Research Methodology
maintain the supportive environment conducive to
b. Research Conceptual Paradigm
health that was included in Henderson's 14
Fundamental Needs, it is necessary to apply
Johnson's "Behavioral System Model," which
affirms that all elements of the human system's
surroundings, including the interior stressors,
should be taken into account.
HEALTH:
- As per Evelyn Adam's Theory, health is defined as
intervention, the focus or center of a professional's
attention when they intervene with a client.
According to Henderson and Johnson's beliefs,
health is the client's ability to satisfy the 14
Fundamental Needs in order to achieve optimal
health, which is influenced by several factors such
as age, health, cultural background, or emotional
imbalance
NURSING:
- Evelyn Adam defined nursing as a function that
assists the individual in making them complete,
whole, or independent in satisfying the 14
Fundamental Needs, with one specific assisting a
nurse needs to execute is to promote to the client
the efficient and effective behavioral functioning
for the purpose of preserving the organization and
integration of the patient's behavior from
demeanors that coexist as related to Virginia
Henderson and Dorothy Johnson’s theories
MAJOR ASSUMPTIONS:
1. Every individual strives for and desires
independence.
2. Every individual is a complex whole, made up of
fundamental needs.
3. When a need is not satisfied, it follows that the
individual is not complete, whole, or
independent.