APPLICATION OF NURSINGTHEORIESINNURSING PROCESS
I. Lydia E. Hall’sI. Lydia E. Hall’sCore, Care and Cure ModelCore, Care and Cure ModelHall’s three aspects of nursing
Concept:Concept: Care should be the primary focus and that nursesCare should be the primary focus and that nurseswere the most qualified to provide the type of carewere the most qualified to provide the type of carethat would enable patients to achieve theirthat would enable patients to achieve theirmaximum potential.maximum potential. The focus of nursing is the provision of intimateThe focus of nursing is the provision of intimatebodily care and the nurse must know how tobodily care and the nurse must know how tomodify the care depending on the pathology andmodify the care depending on the pathology andtreatment while considering the patient’s uniquetreatment while considering the patient’s uniqueneeds and personality.needs and personality.
Nursing as having three aspects, like care,Nursing as having three aspects, like care,core and cure.core and cure. The individual, as unique, capable ofThe individual, as unique, capable ofgrowth and learning and requiring a totalgrowth and learning and requiring a totalperson approach.person approach. Environment to be conducive for theEnvironment to be conducive for thepatient’s self development.patient’s self development.
The major purpose of care is to achieve anThe major purpose of care is to achieve aninter-personal relationship with the individualinter-personal relationship with the individualthat will facilitate the development of corethat will facilitate the development of core(i.e., the development of self-identity and self-(i.e., the development of self-identity and self-direction by the patient.direction by the patient.
ApplicationApplicationThis theory will be applicable inThis theory will be applicable inassessment, planning and implementation of theassessment, planning and implementation of thepatient care.patient care.Three interlocking circles, presenting aThree interlocking circles, presenting aparticular aspect of nursing like care, core andparticular aspect of nursing like care, core andcure.cure.So, the patient whoever comes toSo, the patient whoever comes tohospital will be considered as a Body, person andhospital will be considered as a Body, person anddisease. The nurse who is providing care to thedisease. The nurse who is providing care to thepatient should meet all his bodily care likepatient should meet all his bodily care likebathing, eating, elimination and dressing therebybathing, eating, elimination and dressing therebymeeting his comfort.meeting his comfort.
During care, the nurse shouldDuring care, the nurse shoulddevelop an interpersonal relationship anddevelop an interpersonal relationship andconsider the patient as a person to provide himconsider the patient as a person to provide hima way to express his feelings and emotions toa way to express his feelings and emotions togain self-identity.gain self-identity.After developing an interpersonalAfter developing an interpersonalrelationship, the nurse should see patient andrelationship, the nurse should see patient andfamily through medical care and consider himfamily through medical care and consider himas a diseased person and act an advocate toas a diseased person and act an advocate tocure his condition.cure his condition.
II.II.BETTY NEUMAN SYSTEMSBETTY NEUMAN SYSTEMSMODELMODEL(CONCEPTUAL MODEL)(CONCEPTUAL MODEL)Concept:Concept:Major concepts identified in the model are;Major concepts identified in the model are; ClientClient VariablesVariables EnvironmentEnvironment StressorsStressors Wellness &Wellness & Nursing InterventionsNursing Interventions
ClientsClients are viewed as wholes whose partsare viewed as wholes whose partsare in dynamic interaction.are in dynamic interaction. VariablesVariables are those which simultaneouslyare those which simultaneouslyaffecting the client system. They are,affecting the client system. They are,Physiological, psychological, socio-cultural,Physiological, psychological, socio-cultural,developmental and spiritual.developmental and spiritual. EnvironmentEnvironment is defined as being all theis defined as being all theinternal and external factors that surroundinternal and external factors that surroundand interact with person and client. There areand interact with person and client. There arethree relevant environments: Internal,three relevant environments: Internal,External and Created.External and Created.
StressorsStressors (intrapersonal, interpersonal,(intrapersonal, interpersonal,extra personal) are significant to the conceptextra personal) are significant to the conceptof environment and are described asof environment and are described asenvironmental forces that interact with andenvironmental forces that interact with andpotentially alter system stability.potentially alter system stability. WellnessWellness is a condition where all theis a condition where all thesubsystems are in balance and harmony withsubsystems are in balance and harmony withthe whole of the client and is balanced on thethe whole of the client and is balanced on theactual or potential effort that environmentactual or potential effort that environmentstressors have on the energy level of thestressors have on the energy level of thesystem.system.
Nursing interventions are describedNursing interventions are described bybyusing the term prevention. There are threeusing the term prevention. There are threetypes of prevention: Primary, Secondary, andtypes of prevention: Primary, Secondary, andTertiary.Tertiary.
Model:Model:The Neuman Systems ModelThe Neuman Systems Model((Conceptual Model)Conceptual Model)
ApplicationApplicationThis conceptual model will be applicableThis conceptual model will be applicablefor:for: Assessment of the client systemAssessment of the client system Utilization of the nursing process (Planning)Utilization of the nursing process (Planning) Implementation of preventive interventionsImplementation of preventive interventions
Application of Betty Neuman’s Systems ModelApplication of Betty Neuman’s Systems Modelfor the Patient with Diabetes Mellitusfor the Patient with Diabetes Mellitus
III. HILDEGARD E. PEPLAUIII. HILDEGARD E. PEPLAUTHEORY OF INTERPERSONALTHEORY OF INTERPERSONALRELATIONSRELATIONSConcept:Concept: The four phases of the nurse-patient relationshipThe four phases of the nurse-patient relationshipare; Orientation, Identification, Exploitation andare; Orientation, Identification, Exploitation andResolution.Resolution.OrientationIdentificationExploitationResolutionOn admissionDuring intensivetreatment periodConvalescenceandRehabilitationDischargeOverlapping phases in Nurse-patientrelationships
She proposed and described six nursing roles like:She proposed and described six nursing roles like:Stranger, Resource person, Teacher, Leader,Stranger, Resource person, Teacher, Leader,Surrogate, and Counselor.Surrogate, and Counselor.Factors influencing the blending of the nurse-patient relationship
HILDEGARD E. PEPLAUTHEORY OF INTERPERSONALRELATIONS
ApplicationApplicationThis theory will be applicable inThis theory will be applicable in AssessmentAssessment PlanningPlanning Implementation andImplementation and Evaluation of patient careEvaluation of patient careAlso, allows nursing to move awayAlso, allows nursing to move awayfrom “doing to “to” doing with” clients.from “doing to “to” doing with” clients.
Application:PEPLAU’S FRAMEWORK FOR AN ANXIETY PATIENT
IV. FAYE GLENN ABDELLAHIV. FAYE GLENN ABDELLAHTWENTY-ONE NURSINGTWENTY-ONE NURSINGPROBLEMSPROBLEMSConcept:Concept: HealthHealth Nursing Problems andNursing Problems and Problem SolvingProblem Solving
HealthHealth may be defined as the dynamicmay be defined as the dynamicpattern of functioning whereby there is apattern of functioning whereby there is acontinued interaction with external andcontinued interaction with external andinternal forces that result in the optimal useinternal forces that result in the optimal useof the wellness.of the wellness. Nursing Problems:Nursing Problems: The client’s healthThe client’s healthneeds can be viewed as problems which mayneeds can be viewed as problems which maybe overt as an apparent condition, or covertbe overt as an apparent condition, or covertas a hidden or concealed one.as a hidden or concealed one.
Problem-solvingProblem-solving process involves,process involves,identifying the problem, selecting pertinentidentifying the problem, selecting pertinentdata, formulating hypothesis, testingdata, formulating hypothesis, testinghypothesis through the collection of datahypothesis through the collection of dataand revising the hypothesis when necessaryand revising the hypothesis when necessaryon the basis of conclusion obtained from theon the basis of conclusion obtained from thedata.data.Nursing CenteredClient centeredDisease centeredThe focus of care pendulum
Abdellah’s Twenty-one NursingAbdellah’s Twenty-one NursingproblemsproblemsIt can be classified under four areas like,It can be classified under four areas like,i.i. Physiological needsPhysiological needsii.ii. Safety needsSafety needsiii.iii. Belonging and love needsBelonging and love needsiv.iv. Esteem needsEsteem needs
I. Physiological needs includeI. Physiological needs include To maintain good hygiene and physical comfort.To maintain good hygiene and physical comfort. To promote optimal activity: exercise, rest, andTo promote optimal activity: exercise, rest, andsleep.sleep. To maintain good body mechanics, prevent andTo maintain good body mechanics, prevent andcorrect deformities.correct deformities. To facilitate the maintenance of:To facilitate the maintenance of:- a supply of oxygen to all the body cells,- a supply of oxygen to all the body cells,- nutrition of all body cells.- nutrition of all body cells.- elimination,- elimination,- fluid and electrolyte balance- fluid and electrolyte balance
II. Safety needs includeII. Safety needs include To promote safety through the prevention ofTo promote safety through the prevention ofaccidents, injury, or other trauma andaccidents, injury, or other trauma andthrough the prevention of spread ofthrough the prevention of spread ofinfection.infection. To facilitate the maintenance of sensoryTo facilitate the maintenance of sensoryfunction.function.
III. Belonging and love needsIII. Belonging and love needsincludeinclude To facilitate the maintenance of effectiveTo facilitate the maintenance of effectiveverbal and non-verbal communication.verbal and non-verbal communication. To promote the development of productiveTo promote the development of productiveinter-personal relationships.inter-personal relationships. To facilitate progress towards achievementTo facilitate progress towards achievementof personal spiritual goals.of personal spiritual goals.
IV. Esteem needs includeIV. Esteem needs include To recognize the physiological responseTo recognize the physiological responseof the body to disease conditions –of the body to disease conditions –pathological, physiological, andpathological, physiological, andcompensatory.compensatory. To identify and accept positive andTo identify and accept positive andnegative expressions, feelings andnegative expressions, feelings andreactions, the interrelatedness ofreactions, the interrelatedness ofemotions and organic illness.emotions and organic illness. To create and/or maintain a therapeuticTo create and/or maintain a therapeuticenvironment.environment.
To facilitate awareness of self as an individualTo facilitate awareness of self as an individualwith varying physical, emotional andwith varying physical, emotional anddevelopmental needs.developmental needs. To accept the optimum possible goals in theTo accept the optimum possible goals in thelight of limitations, physical and emotionallight of limitations, physical and emotional To use community resource as an aid inTo use community resource as an aid inresolving problems arising from illness.resolving problems arising from illness. To understand the role of social problems asTo understand the role of social problems asinfluential factors in the case of illness.influential factors in the case of illness.
ApplicationApplicationPhysiological needs andEsteem NeedsAssessment includesAssessment includesThis theory is mainly applicable forThis theory is mainly applicable forassessment and identification of nursing problemsassessment and identification of nursing problemswith nurse-centered orientation.with nurse-centered orientation.For e.g. If we take patient withFor e.g. If we take patient with Severe crushing chest painSevere crushing chest pain Shortness of breathShortness of breath Tachycardia andTachycardia and Profuse diaphoresisProfuse diaphoresis
The patient’s physiological needs includeThe patient’s physiological needs include Hygiene and physical comfortHygiene and physical comfort Exercise, rest and sleepExercise, rest and sleep Maintenance of good body mechanics therebyMaintenance of good body mechanics therebydeformity will be preventeddeformity will be prevented Oxygen supply to be administeredOxygen supply to be administered Nutrition to be metNutrition to be met Elimination needs to be taken careElimination needs to be taken care Fluid and electrolyte balance to be maintainedFluid and electrolyte balance to be maintained
The patient’s Esteem needs includeThe patient’s Esteem needs includeThe nurse should;The nurse should; Recognize the abnormal signs andRecognize the abnormal signs andsymptoms of heart problemsymptoms of heart problem Identify his emotional status towardsIdentify his emotional status towardsdisease conditiondisease condition Provide therapeutic environmentProvide therapeutic environment Facilitate self-awarenessFacilitate self-awareness
Make him to understand the optimum way ofMake him to understand the optimum way ofliving and achieving goalsliving and achieving goals Advice him about availability of communityAdvice him about availability of communityresources to resolve complicationsresources to resolve complications Make him to understand the social factorsMake him to understand the social factorswhich will influence his disease conditionwhich will influence his disease condition