Nursing theory power point

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Nursing theory power point

  1. 1. By :Nelson P. Tagab/Zenaida Z. Zagado
  2. 2.  Theory Has been defined as a supposition or system of ideas that is proposed to explain a given phenomena.
  3. 3. Florence Nightingales’sEnvironmental Theory  considered the founder of educated and scientific nursing and widely known as "The Lady with the Lamp“  wrote the first nursing notes that became the basis of nursing practice and research. The notes, entitled Notes on Nursing: What it is, What is not (1860)  Considered the first nursing theorist.
  4. 4.  Defined Nursing: “The act of utilizing the environment of the patient to assist him in his recovery.” Focuses on changing and manipulating the environment in order to put the patient in the best possible conditions for nature to act. Identified 5 environmental factors: fresh air, pure water, efficient drainage, cleanliness/sanitation and light/direct sunlight. Considered a clean, well-ventilated, quiet environment essential for recovery. Deficiencies in these 5 factors produce illness or lack of health, but with a nurturing environment, the body could repair itself.
  5. 5. Hildegard Peplau’s InterpersonalRelations Theory is a psychiatric nurse, Introduced her interpersonal concept in 1952. Defined Nursing: “An interpersonal process of therapeutic interactions between an Individual who is sick or in need of health services and a nurse especially educated to recognize, respond to the need for help. Nursing is a “maturing force and an educative instrument”
  6. 6.  Identified 4 phases of the Nurse – Patient relationship:  Orientation – individual/family has a “felt need” and seeks professional assistance from a nurse (who is a stranger). This is the problem identification phase.  Identification – where the patient begins to have feelings of belongingness and a capacity for dealing with the problem, creating an optimistic attitude from which inner strength ensues. Here happens the selection of appropriate professional assistance.  Exploitation – the nurse uses communication tools to offer services to the patient, who is expected to take advantage of all services.  Resolution – where patient’s needs have already been met by the collaborative efforts between the patient and the nurse. Therapeutic relationship is terminated and the links are dissolved, as patient drifts away from identifying with the nurse as the helping person.
  7. 7. Virginia Henderson’s Definitionof the Unique Function of Nursing Defined Nursing: “Assisting the individual, sick or well, in the performance of those activities contributing to health or it’s recovery (or to peaceful death) that an individual would perform unaided if he had the necessary strength, will or knowledge”.
  8. 8.  Identified 14 basic needs :  Breathing normally  Eating and drinking adequately  Eliminating body wastes  Moving and maintaining desirable position  Sleeping and resting  Selecting suitable clothes  Maintaining body temperature within normal range  Keeping the body clean and well-groomed  Avoiding dangers in the environment  Communicating with others  Worshipping according to one’s faith  Working in such a way that one feels a sense of accomplishment  Playing/participating in various forms of recreation  Learning, discovering or satisfying the curiosity that leads to normal development and health and using available health facilities.
  9. 9. Madeleine Leininger’s Transcultural CareTheory and Ethnonursing A well-known nurse anthropologist, put her views on transcultural nursing in print in the 1970s and then in 1991 published her book “Culture care diversity and universality: A theory of Nursing” Nursing is a learned humanistic and scientific profession and discipline which is focused on human care phenomena and activities in order to assist, support, facilitate, or enable individuals or groups to maintain or regain their well being (or health) in culturally meaningful and beneficial ways, or to help people face handicaps or death.
  10. 10.  Transcultural nursing as a learned subfield or branch of nursing which focuses upon the comparative study and analysis of cultures with respect to nursing and health-illness caring practices, beliefs and values with the goal to provide meaningful and efficacious nursing care services to people according to their cultural values and health-illness context. Focuses on the fact that different cultures have different caring behaviors and different health and illness values, beliefs, and patterns of behaviors. Awareness of the differences allows the nurse to design culture-specific nursing interventions.
  11. 11.  In order for nurses to assist people of diverse cultures, Lenienger presents three intervention modes:1. Culture care preservation and maintenance .2. Culture care accommodation, negotiation, or both3. Culture care restructuring and repatterning.
  12. 12. Dorothea Orem’s General Theory of Nursing  Defined Nursing: “The act of assisting others in the provision and management of self-care to maintain/improve human functioning at home level of effectiveness.”  Focuses on activities that adult individuals perform on their own behalf to maintain life, health and well-being.  Has a strong health promotion and maintenance focus.
  13. 13. Identified 3 related concepts: 1. Self-care – activities an Individual performs independently throughout life to promote and maintain personal well-being. 2. Self-care deficit – results when self-care agency (Individual’s ability) is not adequate to meet the known self-care needs. 3. Nursing System – nursing interventions needed when Individual is unable to perform the necessary self-care activities:
  14. 14.  Self-care theory is based on four concepts:1. Self care- refers to those activities an individual performs independently throughout life to promote and maintain personal well-being.2. Self care agency- is the individual’s ability to perform self care activities. It consists of two agents: a self-care agent(an individual who performs self-care independently) and a dependent care agent (a person other than the individual who provides the care)3. Self-care requisites- are groups of needs or requirements that Orem identified. They are classified as either:a) Universal self-care requisites - those needs that all people haveb) Developmental self-care requisites - 1. maturational: progress toward higher level of maturation. 2. situational: prevention of deleterious effects related to development.c) Health deviation requisites - those needs that arise as a result of a patients condition. Result from illness, injury or disease or its treatment. They include actions such as seeking health care assistance ,carrying out prescribed therapies, and learning to live with the effects of illness or treatment.
  15. 15. 4. Therapeutic self-care demand-refers to all self- care activities required to meet existing self-care requisites, or in other words, actions to maintain health and well-being.
  16. 16. Self care deficit- results when self care agency is not adequate to meet the known self-care demand. This theory explains not only nursing is needed but also how people can be assisted through five methods of helping: acting or doing for, guiding, teaching, supporting, and providing an environment that promotes individual’s abilities to meet current and future demands.
  17. 17. Orem’s 3 types of Nursing Systems: 1. Wholly compensatory – nurse provides entire self-care for the client.  Example: care of a new born, care of client recovering from surgery in a post-anesthesia care unit 2. Partial compensatory – nurse and client perform care, client can perform selected self-care activities, but also accepts care done by the nurse for needs the client cannot meet independently.  Example: Nurse can assist post operative client to ambulate, Nurse can bring a meal tray for client who can feed himself 3. Supportive-educative – nurse’s actions are to help the client develop/learn their own self-care abilities through knowledge, support and encouragement.  Example: Nurse guides a mother how to breastfeed her baby, Counseling a psychiatric client on more adaptive coping strategies.
  18. 18. Imogene King’s Goal Attainment Theory Nursing is a process of action, reaction, and interaction whereby nurse and client share information about their perception in the nursing situation
  19. 19.  King used a “systems” approach in the development of her dynamic interacting systems framework and in her subsequent Goal-Attainment Theory. She developed a general systems framework and a theory of goal attainment where the framework refers to the three interacting systems -individual or personal, group or interpersonal, and society or social, while the theory of goal attainment pertains to the importance of interaction, perception, communication, transaction, self, role, stress, growth and development, time, and personal space. King emphasizes that both the nurse and the client bring important knowledge and information to the relationship and that they work together to achieve goals.
  20. 20.  The relationship of three interacting systems led to King’s Theory of Goal Attainment are the personal system (individual), the interpersonal system (nurse- patient dialogue), and the social system (the family, the school, and the church). Each system is given different concepts.1) The concepts for the personal system are: perception, self, growth and development, body image, space, and time. These are fundamentals in understanding human being because this refers to how the nurse views and integrates self based from personal goals and beliefs.
  21. 21.  Among all these concepts, the most important is perception, because it influences behavior. King summarized the connections among these concepts as “An individual Perception of self, of body image, of time, of space influences the way he or she responds to object and events in his/her life. As individuals grow and develop through the lifespan experiences with changes in structure and function of their bodies over time influence their perceptions of self”2. Personal systems are individuals, who are regarded as rational, sentient, social beings.
  22. 22.  Concepts related to the personal system are:a) Perception— a process of organizing, interpreting, and transforming information from sense data and memory that gives meaning to ones experience, represents ones image of reality, and influences ones behavior.b) Self— a composite of thoughts and feelings that constitute a persons awareness of individual existence, of who and what he or she is.c) Growth and development— cellular, molecular, and behavioral changes in human beings that are a function of genetic endowment, meaningful and satisfying experiences, and an environment conducive to helping individuals move toward maturity.d) Body image—a persons perceptions of his or her body.e) Time—the duration between the occurrence of one event and the occurrence of another event.f) Space—the physical area called territory that exists in all directions.g) Learning—gaining knowledge.
  23. 23. The concepts associated for the interpersonal system are: interaction, communication, transaction, role, and stress. King refers to two individuals as dyads, three as triads and four or more individuals as small group or large group . This shows how the nurse interrelates with a co- worker or patient, particularly in a nurse-patient relationship. Communication between the nurse and the client can be verbal or nonverbal. Collaboration between the Dyads (nurse-patient) is very important for the attainment of the goal.
  24. 24.  The concepts associated with this system are:a) Interactions—the acts of two or more persons in mutual presence; a sequence of verbal and nonverbal behaviors that are goal directed.b) Communication—the vehicle by which human relations are developed and maintained; encompasses intrapersonal, interpersonal, verbal, and nonverbal communication.c) Transaction—a process of interaction in which human beings communicate with the environment to achieve goals that are valued; goal-directed human behaviors.d) Role—a set of behaviors expected of a person occupying a position in a social system.e) Stress—a dynamic state whereby a human being interacts with the environment to maintain balance for growth, development, and performance, involving an exchange of energy and information between the person and the environment for regulation and control of stressors.f) Coping—a way of dealing with stress.
  25. 25. action reaction Disturbance(problem) Interpersonal Mutual goal setting and decision making dyad Exploration if means to achieve the(Nurse-client)- goal interaction Agreement on means to achieve the goals Transaction directly observable Goal attainment King’s definition of interaction and transaction
  26. 26. 3.The final interacting system is the social system. This shows how the nurse interacts with co workers, superiors, subordinates and the client environment in general. These are groups of people within the community or society that share a common goals, values and interests. It provides a framework for social interaction and relationships and establishes rules of behavior and courses of action. Social systems are organized boundary systems of social roles, behaviors, and practices developed to maintain values and the mechanisms to regulate the practices and roles.
  27. 27.  The concepts related to social systems are:a) Organization—composed of human beings with prescribed roles and positions who use resources to accomplish personal and organizational goals.b) Authority—a transactional process characterized by active, reciprocal relations in which members values, backgrounds, and perceptions play a role in defining, validating, and accepting the authority of individuals within an organization.c) Power—the process whereby one or more persons influence other persons in a situation.d) Status—the position of an individual in a group or a group in relation to other groups in an organization.e) Decision making—a dynamic and systematic process by which goal-directed choice of perceived alternatives is made and acted upon by individuals or groups to answer a question and attain a goal.f) Control—being in charge.
  28. 28.  Among the three systems, the conceptual framework of Interpersonal system had the greatest influence on the development of her theory. She stated that “Although personal systems and social systems influence quality of care, the major elements in a theory of goal attainment are discovered in the interpersonal systems in which two people, who are usually strangers, come together in a health care organization to help and to be helped to maintain a state of health that permits functioning in roles”
  29. 29. Finally according to her, nursings focus is on the care of the patient, and its goal is the health care of patients and groups of patients.
  30. 30. Callista Roy’s Adaptation Theory Sister Callista Roy defines adaptation as the process and outcome whereby the thinking and feeling person uses conscious awareness and choice to create human and environmental integration. This model comprises the four domain concepts of person, health, environment, and nursing and involves a six step nursing process
  31. 31. 1) Roys models sees the person as "a biopsychosocial being in constant interaction with a changing environment“ The person is an open, adaptive system who uses coping skills to deal with stressors.2) Roy sees the environment as "all conditions, circumstances and influences that surround and affect the development and behaviour of the person". Roy describes stressors as stimuli and uses the term residual stimuli to describe those stressors whose influence on the person is not clear .
  32. 32. 3) Originally, Roy wrote that health and illness are on a continuum with many different states or degrees possible. More recently, she states that health is the process of being and becoming an integrated and whole person4) Roys goal of nursing is "the promotion of adaptation in each of the four modes, thereby contributing to the persons health, quality of life and dying with dignity". These four modes are physiological, self-concept, role function and interdependence.
  33. 33. A. In the Physiologic mode, adaptation involves the maintenance of physical integrity. Basic human needs such as nutrition, oxygen, fluids, and temperature regulation are identified with this mode. In assessing a family, the nurse would ask how the family provides for the physical and survival needs of the family members.B. A function of the Self-concept mode is the need for maintenance of psychic integrity. Perceptions of one’s physical and personal self are included in this mode. Families also have concepts of themselves as a family unit. Assessment of the family in this mode would include the amount of understanding provided to the family members, the solidarity of the family. the values of the family, the amount of companionship provided to the members, and the orientation (present or future) of the family.
  34. 34. C. The need for social integrity is emphasized in the Role function mode. When human beings adapt to various role changes that occur throughout a lifetime, they are adapting in this mode. According to Hanson, the family’s role can be assessed by observing the communication patterns in the family. Assessment should include how decisions are reached, the roles and communication patterns of the members, how role changes are tolerated, and the effectiveness of communication. For example, when a couple adjusts their lifestyle appropriately following retirement from full-time employment, they are adapting in this mode.
  35. 35. D.The need for social integrity is also emphasized in the interdependence mode. Interdependence involves maintaining a balance between independence and dependence in one’s relationships with others. Dependent behaviors include affection seeking, help seeking, and attention seeking. Independent behaviors include mastery of obstacles and initiative taking. According to Hanson, when assessing this mode in families, the nurse tries to determine how successfully the family lives within a given community. The nurse would assess the interactions of the family with the neighbors and other community groups, the support systems of the family, and the significant others .
  36. 36.  The goal of nursing is to promote adaptation of the client during both health and illness in all four of the modes. Actions of the nurse begin with the assessment process, The family is assessed on two levels. First, the nurse makes a judgment with regard to the presence or absence of maladaptation. Then, the nurse focuses the assessment on the stimuli influencing the family’s maladaptive behaviors. The nurse may need to manipulate the environment, an element or elements of the client system, or both in order to promote adaptation .
  37. 37. Roy employs a six-step nursing process which includes: assessment of behaviour, assessment of stimuli, nursing diagnosis, goal setting, intervention and evaluation. In the first step, the persons behaviour in each of the four modes is observed. This behaviour is then compared with norms and is deemed either adaptive or ineffective. The second step is concerned with factors that influence behaviour. Stimuli are classified as focal, contextual or residual.
  38. 38.  The nursing diagnosis is the statement of the ineffective behaviours along with the identification of the probable cause. In the fourth step, goal setting is the focus. Goals need to be realistic and attainable and are set in collaboration with the person. Intervention occurs as the fifth step, and this is when the stimuli are manipulated. It is also called the doing phase. In the final stage, evaluation takes place. The degree of change as evidenced by change in behaviour, is determined. Ineffective behaviours would be reassessed, and the interventions would be revised
  39. 39. Jean Watson’s The Philosophy and Science of Caring  The Philosophy and Science of Caring has four major concepts: human being, health, environment/society, and nursing. Jean Watson refers to the human being as "a valued person in and of him or herself to be cared for, respected, nurtured, understood and assisted; in general a philosophical view of a person as a fully functional integrated self. Human is viewed as greater than and different from the sum of his or her parts."
  40. 40. 1) Health is defined as a high level of overall physical, mental, and social functioning; a general adaptive-maintenance level of daily functioning; and the absence of illness, or the presence of efforts leading to the absence of illness.2) Watsons definition of environment/society addresses the idea that nurses have existed in every society, and that a caring attitude is transmitted from generation to generation by the culture of the nursing profession as a unique way of coping with its environment.3) The nursing model states that nursing is concerned with promoting health, preventing illness, caring for the sick, and restoring health. It focuses on health promotion, as well as the treatment of diseases. Watson believed that holistic health care is central to the practice of caring in nursing. She defines nursing as "a human science of persons and human health- illness experiences that are mediated by professional, personal, scientific, esthetic and ethical human transactions."
  41. 41. 4) The nursing process outlined in the model contains the same steps as the scientific research process: assessment, plan, intervention, and evaluation. The assessment includes observation, identification, and review of the problem, as well as the formation of a hypothesis. Creating a care plan helps the nurse determine how variables would be examined or measured, and what data would be collected. Intervention is the implementation of the care plan and data collection. Finally, the evaluation analyzes the data, interprets the results, and may lead to an additional hypothesis.
  42. 42. Watsons model makes sevenassumptions: Caring can be effectively demonstrated and practiced only interpersonally. Caring consists of carative factors that result in the satisfaction of certain human needs. Effective caring promotes health and individual or family growth. Caring responses accept the patient as he or she is now, as well as what he or she may become. A caring environment is one that offers the development of potential while allowing the patient to choose the best action for him or herself at a given point in time. A science of caring is complementary to the science of curing. The practice of caring is central to nursing.
  43. 43. The first three carative factors are the "philosophicalfoundation" for the science of caring, while theremaining seven derive from that foundation. The tenprimary carative factors are: The formation of a humanistic-altruistic system of values, which begins at an early age with the values shared by parents. The system of values is mediated by the nurses life experiences, learning gained, and exposure to the humanities. It is perceived as necessary to the nurses maturation which in turn promotes altruistic behavior toward others. The installation of faith-hope, which is essential to the carative and curative processes. When modern science has nothing else to offer a patient, a nurse can continue to use faith-hope to provide a sense of well-being through a belief system meaningful to the individual.
  44. 44.  The cultivation of sensitivity to ones self and to others, which explores the need of nurses to feel an emotion as it presents itself. The development of a nurses own feeling is needed to interact genuinely and sensitively with patients. By striving to become more sensitive, the nurse is more authentic. This encourages self-growth and self- actualization in both the nurse and the patients who interact with the nurse. The nurses promote health and higher-level functioning only when they form person-to- person relationships. The development of a helping-trust relationship, which includes congruence, empathy, and warmth. The strongest tool a nurse has is his or her mode of communication, which establishes a rapport with the patient, as well as caring by the nurse. Communication includes verbal and nonverbal communication, as well as listening that connotes empathetic understanding.
  45. 45.  The promotion and acceptance of the expression of both positive and negative feelings, which need to be considered and allowed for in a caring relationship because of how feelings alter thoughts and behavior. The awareness of the feelings helps the nurse and patient understand the behavior it causes. The systematic use of the scientific method for problem-solving and decision-making, which allows for control and prediction, and permits self-correction. The science of caring should not always be neutral and objective.
  46. 46.  The promotion of interpersonal teaching-learning, since the nurse should focus on the learning process as much as the teaching process. Understanding the persons perception of the situation assists the nurse to prepare a cognitive plan. The provision for a supportive, protective and/or corrective mental, physical, socio-cultural, and spiritual environment, which Watson divides into interdependent internal and external variables, manipulated by the nurse in order to provide support and protection for the patients mental and physical health. The nurse must provide comfort, privacy, and safety as part of the carative factor.
  47. 47.  Assistance with satisfying human needs based on a hierarchy of needs similar to Maslows. Each need is equally important for quality nursing care and the promotion of the patients health. In addition, all needs deserve to be valued and attended to by the nurse and patient. The allowance for existential-phenomenological forces, which helps the nurse to reconcile and mediate the incongruity of viewing the patient holistically while at the same time attending to the hierarchical ordering of needs. This helps the nurse assist the patient to find strength and courage to confront life or death. Phenomology is a way of understanding the patient from his or her frame of reference. Existential psychology is the study of human existence.
  48. 48.  Watsons hierarchy of needs begins with lower-order biophysical needs, which include the need for food and fluid, elimination, and ventilation. Next are the lower-order psychophysical needs, which include the need for activity, inactivity, and sexuality. Finally, are the higher order needs, which are psychosocial. These include the need for achievement, affiliation, and self- actualization.
  49. 49. Betty Neumans Systems Model “Health is a condition in which all parts and subparts are in harmony with the whole of the client.” Developed this model based on the individual’s relationship to stress, the reaction to it, and reconstitution factors that are dynamic in nature. Reconstitution is the state of adaptation to stress.
  50. 50.  KEY CONCEPTS Viewed the client as an open system consisting of a basic structure or central core of energy resources which represent concentric circles Each concentric circle or layer is made up of the five variable areas which are considered and occur simultaneously in each client concentric circles. These are:1. Physiological - refers of bodily structure and function.2. Psychological - refers to mental processes, functioning and emotions.3. Sociocultural - refers to relationships; and social/cultural functions and activities.4. Spiritual - refers to the influence of spiritual beliefs.5. Developmental - refers to life’s developmental processes.
  51. 51.  Basic Structure Energy Resources-This is otherwise known as the central core, which is made up of the basic survival factors common to all organisms. These include the following:1. Normal temperature range – body temperature regulation ability2. Genetic structure – Hair color and bodily features3. Response pattern – functioning of body systems homeostatically4. Organ strength or weakness5. Ego structure6. Knowns or commonalities – value system The persons system is an open system - dynamic and constantly changing and evolving Stability, or homeostasis, occurs when the amount of energy that is available exceeds that being used by the system. A homeostatic body system is constantly in a dynamic process of input, output, feedback, and compensation, which leads to a state of balance
  52. 52.  Central core of energy resources surrounded by two concentric boundaries or rings referred to as lines of resistance. Lines of Resistance The last boundary that protects the basic structure or it represents the internal factors that help client defend against s stressor Protect the basic structure and become activated when environmental stressors invade the normal line of defense. An example is that when a certain bacteria enters our system, there is an increase in leukocyte count to combat infection. If the lines of resistance are effective, the system can reconstitute and if the lines of resistance are not effective, the resulting energy loss can result in death. Outside the lines of resistance are two lines of defense:
  53. 53. 1. Normal Line of Defense Represents client’s usual wellness level. Can change over time in response to coping or responding to the environment, which includes intelligence, attitudes, problem solving and coping abilities. Example is skin which is constantly smooth and fair will eventually form callous over times.2. Flexible Lines of Defense Is the outer boundary to the normal line of defense, the line of resistance, and the core structure. Keeps the system free from stressors and is dependent on the amount of sleep, nutritional status, as well as the quality and quantity of stress an individual experiences. If the flexible line of defense fails to provide adequate protection to the normal line of defense, the lines of resistance become activated.
  54. 54. Neuman categorizes Stressors as: Stressors Are capable of producing either a positive or negative effect on the client system. Is any environmental force which can potentially affect the stability of the system:1. Intrapersonal - occur within person, example is infection, thoughts and feelings2. Interpersonal - occur between individuals, e.g. role expectations3. Extrapersonal - occur outside the individual, e.g. job or finance concerns A person’s reaction to stressors depends on the strength of the lines of defense. When the lines of defense fails, the resulting reaction depends on the strength of the lines of resistance. As part of the reaction, a person’s system can adapt to a stressor, an effect known as reconstitution.
  55. 55. Reconstitution Is the increase in energy that occurs in relation to the degree of reaction to the stressor which starts after initiation of treatment for invasion of stressors. May expand the normal line of defense beyond its previous level, stabilize the system at a lower level, or return it to the level that existed before the illness. Nursing interventions focus on retaining or maintaining system stability. By means of primary, secondary and tertiary interventions, the person (or the nurse) attempts to restore or maintain the stability of the system.
  56. 56. Prevention Is the primary nursing intervention. Focuses on keeping stressors and the stress response from having a detrimental effect on the body.1. Primary prevention -focuses on protecting the normal line of defense and strengthening the flexible line of defense. This occur before the system reacts to a stressor and strengthens the person (primarily the flexible line of defense) to enable him to better deal with stressors and also manipulates the environment to reduce or weaken stressors. Includes health promotion and maintenance of wellness.2. Secondary prevention- focuses on strengthening internal lines of resistance, reducing the reaction of the stressor and increasing resistance factors in order to prevent damage to the central core. This occurs after the system reacts to a stressor. This includes appropriate treatment of symptoms to attain optimal client system stability and energy conservation.3. Tertiary prevention -focuses on readaptation and stability, and protects reconstitution or return to wellness after treatment. This occurs after the system has been treated through secondary prevention strategies. Tertiary prevention offers support to the client and attempts to add energy to the system or reduce energy needed in order to facilitate reconstitution.
  57. 57. Rosemarie Rizzo Parse’s Theoryof Human BecomingNursing is a scientific discipline, the practice of which is a performing art
  58. 58. Three assumption about Human Becoming:1. Human becoming is freely choosing personal meaning in situation in the intersubjective process of relating value priorities2. becoming is co-creating rhythmic patterns or relating in mutual process in the universe3. Human becoming is co-transcending multidimensionally with emerging possibilities.
  59. 59.  These three assumptions focus on meaning, rhythmicity, and contrascendence:1. Meaning arises from a person’s interrelationship with the world and refers to happenings to which the person attaches varying degree of significance.2. Rhythmicity is the movement toward greater diversity3. Contrascendence is the process of reaching out beyond the self.
  60. 60.  Model of human becoming emphasizes how individuals choose and bear responsibility for patterns of personal health. Contends that the client , not the nurse , is the authority figure and decision maker. The nurse’s role involves helping individuals and families in choosing the possibilities for changing the health process.
  61. 61. MARTHA ROGERS SCIENCE OF UNITARYHUMAN BEINGS Described the irreducible nature of individuals as being different from the sum of their parts She theorized that the identity of nursing as a science arises from the integrality of people and the environment that coordinates with a multidimensional universe of open systems
  62. 62.  Rogers model provides the way of viewing the unitary human being. Humans are viewed as integral with the universe: the unitary human being and the environment are one, not dichotomous
  63. 63.  The basic characteristics that describe the life process of human include energy field, openness, pattern, and pan-dimensionality. The basic concepts of the theory include unitary human being, environment, and homeodynamic principles.
  64. 64. Concepts of Rogers mode1. Energy field The energy field is the fundamental unit of both the living and nonliving. This energy field "provides a way to perceive people and environment as irreducible wholes". The energy fields continuously varies in intensity, density, and extent.2. Openness The human field and the environmental field are constantly exchanging their energy back and forth. There are no boundaries or barriers that inhibit energy flow between the fields.3. Pattern Pattern is defined as the distinguishing characteristic of an energy field. "Pattern is an abstraction and it gives identity to the field“.
  65. 65. 4. Pan-dimensionality Pan-dimensionality is defined as "non linear domain without spatial or temporal attributes". The parameters that humans use in language to describe events are arbitrary. The present is relative; there is no temporal ordering of lives.5. Unitary Human Being (person A unitary human being is an "irreducible, indivisible, pan-dimensional (four-dimensional) energy field identified by pattern and manifesting characteristics that are specific to the whole and which cannot be predicted from knowledge of the parts" and "a unified whole having its own distinctive characteristics which cannot be perceived by looking at, describing, or summarizing the parts". The person has the capacity to participate knowingly and probabilistically in the process of change.6. Environment The environment is an "irreducible, pan-dimensional energy field identified by pattern and integral with the human field". The two fields coexist and are integral. Manifestations emerge from this field and are perceived by the person.
  66. 66. 7. Health Rogers defined health as an expression of the life process; they are the "characteristics and behavior emerging out of the mutual, simultaneous interaction of the human and environmental fields". Health and illness are the part of the same continuum. The multiple events taking place along lifes axis denote the extent to which man is achieving his maximum health potential and vary in their expressions from greatest health to those conditions which are incompatible with maintaining life processes.8. Nursinga) Nursing as a science The theory asserts the independent science of nursing because an organized body of knowledge which is specific to nursing is arrived at by scientific research and logical analysis.b) Nursing as an art Rogers claimed that the creative use of science for the betterment of humans and the creative use of its knowledge is the art of its nursing.
  67. 67. C. Assumptions about people and nursing Nursing exists to serve people. It is the direct and overriding responsibility to the society. The safe practice of nursing depends on the nature and amount of scientific nursing knowledge the individual brings to practice. People need knowledgeable nursing.9. Homeodynamic principles-The principles of homeodynamic postulates the way unitary human beings are perceived. The fundamental unit of the living system is an energy field.10. Resonancy-Resonancy is an ordered arrangement of rhythm characterizing both human field and environmental field that undergoes continuous dynamic metamorphosis in the human environmental process.
  68. 68. 11. Helicy - Helicy describes the unpredictable, but continuous, nonlinear evolution of energy fields as evidenced by non repeating rhythmicties The principle of helicy postulates an ordering of humans evolutionary emergence.12. Integrality - Integrality is the mutual, continuous relationship of the human energy field and the environmental field. Changes occur by the continuous repatterning of the human and environmental fields by resonance waves. The fields are one and integrated, but unique from each other.

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