TFN

1. Hildegard Peplau-Interpersonal RelationsModel
 Basedon psychodynamicnursing
 usingan understandingof one’sownbehaviorto
helpothersidentifytheirdifficulties
 Appliesprinciplesof humanrelations
 Patienthasa feltneed
Peplau’sConcepts
1. Person
 An individual;adevelopingorganismwhotriesto
reduce anxietycausedbyneeds
 Livesininstable equilibrium
2. Environment
 Notdefined
3. Health
 Impliesforwardmovementof the personalityand
humanprocessestowardcreative,constructive,
productive,personal,andcommunityliving
4. Nursing
 A significant,therapeutic,interpersonalprocess
that functionscooperativelywithotherstomake
healthpossible
 Involvesproblem-solving
Fay Abdella- Topologyof21 NursingProblems
 A listof 21 nursingproblems
 Conditionpresentedorfacedbythe patientor
family.
 Problemsare in3 categories
o physical,social andemotional
 The nurse must be a good problemsolver
Abdella’sConcepts
1. Nursing
 A helpingprofession
 A comprehensive service tomeetpatient’s needs
 Increasesorrestoresself-helpability
 Uses 21 problemstoguide nursingcare
2. Health
 Excludesillness
 No unmetneedsandnoactual or anticipated
impairments
3. Person
 One whohas physical,emotional,orsocial needs
 The recipientof nursing care.
4. Environment
 Didnot discussmuch
 Includesroom, home,andcommunity
Dorothy Johnson-Behavioral SystemsModel
 The personis a behavioral systemcomprisedof a
setof organized,interactive,interdependent,and
integratedsubsystems
 Constancyismaintainedthroughbiological,
psychological,andsociological factors.
 A steadystate ismaintainedthroughadjustingand
adaptingto internal andexternal forces.
Johnson’s7 Subsystems
 Affiliative subsystem - social bonds
 Dependency - helpingornuturing
 Ingestive - foodintake
 Eliminative- excretion
 Sexual - procreationandgratification
 Aggressive - self-protectionandpreservation
 Achievement- effortstogainmasteryandcontrol
Johnson’sConcepts
1. Person
 A behavioral systemcomprisedof subsystems
constantlytryingtomaintaina steadystate
2. Environment
 Notspecificallydefinedbutdoessaythere isan
internal andexternal environment
3. Health
 Balance and stability.
4. Nursing
 External regulatoryforce thatisindicatedonly
whenthere isinstability
Dorothea Orem- Self-Care Model
 Self-care comprisesthose activitiesperformed
independentlybyanindividual topromote and
maintainpersonwell-being
 Self care agencyis the individual’sabilityto
performself care activities
 Self- care deficitoccurswhenthe personcannot
carry out self-care
 The nurse thenmeetsthe self-care needsbyacting
or doingfor;guiding,teaching,supportingor
providingthe environmenttopromote patient’s
ability
 Whollycompensatorynursingsystem-Patient
dependent
 Partiallycompensatory- Patientcanmeetsome
needsbutneedsnursingassistance
 Supportive educative-Patientcanmeetself care
requisites,butneedsassistance withdecision
makingor knowledge

2. Betty Neuman- Health Care SystemsModel
 The personis a complete system,withinterrelated
parts
 maintainsbalance andharmonybetweeninternal
and external environmentbyadjustingtostress
and defendingagainsttension-producingstimuli
 Focusesonstressand stressreduction
 Primarilyconcernedwitheffects of stresson
health
 Stressorsare any forcesthat alterthe system’s
stability
 Flexible linesof resistance - Surroundbasiccore
 Internal factorsthat helpdefendagainststressors
 Normal line of resistance - Normal adaptation
state
 Flexible line of defense- Protectivebarrier,
changing,affectedbyvariables
 Wellnessisequilibrium
Nursinginterventionsare activatesto:
 strengthenflexiblelinesof defense
 strengthenresistancetostressors
 maintainadaptation
Jean Watson - Philosophyand Science of Caring
 Caringcan be demonstratedandpracticed
 Caringconsistsof carative factors
 Caringpromotesgrowth
 A caringenvironmentacceptsapersonashe isand
looksto whatthe personmay become
 A caringenvironmentoffersdevelopmentof
potential
 Caringpromoteshealthbetterthancuring
 Caringis central to nursing
Watson’s10 Carative Factors
 Forminghumanistic-altruisticvalue system
 Instillingfaith-hope
 Cultivatingsensitivitytoself andothers
 Developinghelping-trustrelationship
 Promotingexpressionof feelings
 Usingproblem-solvingfordecisionmaking
 Promotingteaching-learning
 Promotingsupportiveenvironment
 Assistingwithgratificationof humanneeds
 Allowingforexistential-phenomenological forces
Watson’sConcepts
 Person
o Human beingtobe valued,caredfor,
respected,nurtured,understoodand
assisted
 Environment
o Society
 Health
o Complete physical,mentalandsocial well-
beingandfunctioning
 Nursing
o Concernedwithpromotingandrestoring
health,preventingillness

3. 1. Human Being (Humanity) - an integratedwhole
composedof an internal physical,psychological andsocial
nature withvaryingdegreesof self care ability(
-a substantial orreal unitywhose partsare formedand
attainperfectionthroughthe differentiationof the
whole duringthe processof development.Hasthe
capabilitytoreflect,symbolize,anduse symbols.
-whenreferringtohumans,Oremusesthe termindividual,
patient,multiperson,self care agent,dependent
care agent.
2. Health - healthandhealthyare termsto describe living
thingsaccordingto Orem,theyare structurallyand
funcitonallywholeorsound,includesthatwhichmake a
personhuman,she define healthas"astate of physical,
mental andsocial sell-being,andnotmerelythe absence
of disease orinfirmity ).Oremseeshealthasa state of well
being,whichrefertoa person'sconditionof existence,
characterizedbycontentment,pleasure,happiness,
movementtowarsself ideals.The presentsociopolitical
climate influencedOremtoexandher definitionof health
to include the conceptof preventive healthcare.She uses
the termshealth,healthstate,andwell being.
3. Nursing- accordingto Oremits an art throughwhichthe
practitionerof nursinggivesspecializedassisstance to
personswithdisabilitiesthatneededgreaterthanordinary
assistance tomeedthe dailyneedsforself care.Itconsists
of actionsdeliberatelyselectedandperformedbynurses
to helppatientsundertheircare tomaintainorchange
conditionsinthemselvesortheirenvironment.Terms
used:nursing,nursingagency.
4. Environment- the sorroundingof the patientsmay
affecttheirabilitytoperformtheirselfcare activity.
Includestwodimensionsa.physical,chemical,biologic
featuresandsocioeconomicfeatures.
a. Physical,chemical andbiologicfeatures:atmosphere,
pollutants,weather,pets,infectiousorganisms
b. Socioeconomicfeatures:family,community,gender,
genderroles,cultural roles,cultural prescription
of authority.
Termsused- environment,environmentfeatures
Patricia Benner –Novice to expert
Nursing
PatriciaBennerdescribednursingasan
“enablingcondition of connectionandconcern”) which
showsa highlevel of emotional involvementinthe nurse-
clientrelationship.She viewed nursingpractice asthe care
and studyof the livedexperience of health,illness,
and disease andthe relationshipsamongthese three
elements.
Person
Bennerstatedthata “self-interpretingbeing,thatis,the
persondoesnotcome intothe worldpredefinedbutgets
definedinthe course of livingalife.A personalsohas…an
effortlessandnon-reflectiveunderstandingof the self in
the world.The personisviewedasa participantin
commonmeanings
Bennerbelieved thatthere are significantaspectsthat
make up a person.She hadconceptualizedthe major
aspectsof understandingthatthe personmustdeal as:
The role of the situation
The role of the body.
The role of personal concerns.
The role of temporarility.
Health
PatriciaBennerfocused“onthe livedexperienceof being
healthy andill.”She definedhealthaswhatcan be
assessed,while well-beingisthe humanexperience of
healthor wholeness.Well-beingandbeingill are
recognizedasdifferentwaysof beinginthe world.Health
isdescribedas not justthe absence of disease andillness.
Also,a personmayhave a diseaseandnotexperience
illnessbecauseillnessisthe humanexperience of loss
or dysfunction,whereas disease iswhatcanbe assessedat
the physical level.
Environment
Insteadof usingthe term“environment”,Bennerusedthe
term“situation”,because it suggests asocial environment
withsocial definitionandmeaning.She usedthe
phenomenological terms
ofbeingsituatedandsituatedmeaning,whichare defined
by the person’s engagedinteraction,interpretationan
understandingof the situation.