TFN Midterms ILG 1
TFN Midterms ILG 1
TFN Midterms ILG 1
INSTRUCTIONAL
LEARNING GUIDE
NCM 100
Theoretical Foundations
In
Nursing
FIRST SEMESTER F.Y. 2020-2021
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MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
MIDTERMS COVERAGE
CHAPTER 1
INTRODUCTION OF NURSING THEORY
This chapter comprises of the basic concepts and terms that will be widely used in
the succeeding chapters and lessons. It will enable the learners to better understand the
subject matter.
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MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
Activities:
1. Self-Assessment Exercises
2. Theory Critiquing
Key Terms:
Nursing Theorists
Conceptual Models
Grand Theories
Middle Range Theories
Let’s Begin!
A. PHILOSOPHIES
I. FLORENCE NIGHTINGALE
Was born in Florence Italy
May 12, 1820
was provided with very broad education
fought the bureaucracy for bandages, food, fresh bedding, & cleaning supplies for
the soldiers during the Crimean War
great concern for the well-being of the English soldiers
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MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
5. Variety
- Variety of environment was a critical aspect affecting the patient’s recovery
- effect of the body & the mind
- reading, needlework, writing, cleaning activities to relieve boredom.
Metaparadigm In Nursing
Nursing
- “what nursing has to do...is to put the patient in the best condition for
nature to act upon him”
- signifies the proper use of the major areas in environment
Person
- Not defined by Nightingale specifically, but are defined in relationship to
their environment & the impact on them
Environment
- She focused on ventilation, warmth, noise, light, & cleanliness
- All that surrounds human beings is considered in relation to his state of
health
Health
- No definition of health specifically
- pathology teaches the harm disease has done
- “nature alone cures”
- Nursing should provide care to the healthy & ill & discussed health
promotion as an activity in which nurses should engage
Teacher’s Insight
The focus of nursing in this model is to alter the patient’s environment in order to
affect change in his or her health. The environmental factors that affect health as
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identified in the theory are: fresh air, pure water, sufficient food supplies, efficient
drainage, cleanliness of he patient and environment and light (particulary direct
sunlight). If any of these areas is lacking, the patient may experience diminished
MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
"The unique function of the nurse is to assist the individual, sick or well, in the
performance of those activities contributing to health or its recovery (or to peaceful
death) that he would perform unaided if he had the necessary strength, will or
knowledge. And to do this in such a way as to help him gain independence as rapidly
as possible”.
14 Basic Needs
Physiological
1. Breath normally
2. Eat and drink adequately
3. Eliminate body wastes
4. Move and maintain desirable postures
5. Sleep and rest
6. Select suitable clothes - dress and undress
7. Maintain body temperature within normal range by adjusting clothing and
modifying the environment.
8. Keep the body clean and well groomed and protect the integument.
9. Avoid dangers in the environment and avoid injuring others.
10.Communicate with others in expressing emotions, needs, fears, or
opinions.
11. Learn, discover, or satisfy the curiosity that leads to normal
developmentand health and use the available health facilities.
Sociological
12. Work in such a way that there is a sense of accomplishment.
13. Play or participate in various forms of recreation
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MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
Spiritual
14.Worship according to one’s faith
Metaparadigm In Nursing
Nursing
- Henderson asserted that nurse function independently from the physician,
but they must promote the treatment plan prescribe by the physician.
- Although part of the health team, the nurse must act independently but in
coordination with with the therapeutic plan developed by the team
Person
- Is an individual who requires assistance to achieve health and
independence or in some case, a peaceful death.
Environment
- Individuals in relation to families
- Supports tasks of private and public agencies
- Society expects nurses to act for individuals who are unable to function
independently
- Basic nursing care involves providing conditions under which the patient
can perform the 14 activities unaided
Health
- Definition based on individual’s ability to function independently as
outlined in the 14 components.
- Nurses need to stress promotion of health and prevention and cure of
disease.
- Good health is a challenge.
- Affected by age, cultural background, physical, and intellectual capacities,
and emotional balance
- Impact on health by working of various social issues.
21 Nursing Problems
1. To maintain good hygiene
2. To promote optimal activity; exercise rest and sleep
3. To promote safety
4. To maintain good body mechanics
5. To facilitate the maintenance of a supply of oxygen
6. To facilitate maintenance of nutrition
7. To facilitate maintenance of elimination
8. To facilitate the maintenance of F&E balance
9. To recognize the physiologic responses of the body to disease condition
10. To facilitate the maintenance of regulatory mechanisms and functions
11. To facilitate the maintenance of sensory function
12. To identify and accept the positive and negative expressions, feelings and
reactions
13. To identify and accept the interrelatedness of emotions and illness
14. To facilitate the maintenance of effective verbal and non-verbal communication
15. To promote the development of productive interpersonal relationship
16. To facilitate the progress towards achievement of personal spiritual goals
17. To create and maintain a therapeutic environment
18. To facilitate awareness of self as an individual with varying needs
19. To accept the optimum possible goals
20. To use community resources as an aid in resolving problems arising from illness
21. To understand the role of social problems as influencing factors
Teacher’s Insight
Metaparadigm In Nursing
Person/Human being
Human being refers to “….. 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. He, human is viewed as greater than and
different from, the sum of his or her parts”.
Health
Watson adds the following three elements to WHO definition of health:
– A high level of overall physical, mental and social functioning
– A general adaptive-maintenance level of daily functioning
– The absence of illness (or the presence of efforts that leads its absence)
Environment/society
According to Watson, caring (and nursing) has existed in every society.
A caring attitude is not transmitted from generation to generation.
It is transmitted by the culture of the profession as a unique way of coping with its
environment.
Nursing
“Nursing is concerned with promoting health, preventing illness, caring for the sick
and restoring health”.
It focuses on health promotion and treatment of disease. She believes 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”.
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MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
B. GRAND THEORIES
V. MADELEINE LEININGER
Developed the Transcultural Nursing Model.
Advocated that nursing is a humanistic and scientific mode of helping a client
through specific cultural caring process to improve or maintain a health condition.
Leininger is the founder of the transcultural nursing movement in education research
and practice.
Transcultural Nursing
Teacher’s Insight
Navigating the unique cultural needs of your patients is very vital before
rendering care to them. Without doing so, you might accidentally offend your
patients or their families by not knowing about a crucial cultural practice and you
could also witness something that goes against your personal beliefs and
convictions and different from the nursing philosophies and principles that can at
the same time affect the delivery of health care. Thus, it is very important to
gather the cultural beliefs of your clients during the collection of data and health
history taking. Second, respect their cultural practices as long as it does not
threaten or contribute to risking their health status.
The health promotion model (HPM) proposed by Nola J Pender (1982; revised, 1996)
was designed to be a “complementary counterpart to models of health protection.”
It defines health as a positive dynamic state not merely the absence of disease.
Health promotion is directed at increasing a client’s level of well being.
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MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
The health promotion model describes the multi dimensional nature of persons as
they interact within their environment to pursue health.
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MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
Psychodynamic nursing
Metaparadigm In Nursing
4. Nursing
- A significant therapeutic interpersonal process. It functions cooperatively
with other human process that make health possible for individuals in
communities
5. Person
a. A developing organism that tries to reduce anxiety caused by needs
Environment
- Existing forces outside the organism and in the context of culture
6. Health
- A word symbol that implies forward movement of personality and other
ongoing human processes in the direction of creative,
constructive, productive, personal and community living.
Roles of nurse
Stranger : receives the client in the same way one meets a stranger in other life
situations provides an accepting climate that builds trust.
Teacher : who imparts knowledge in reference to a need or interest
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MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
Resource Person : one who provides a specific needed information that aids in the
understanding of a problem or new situation
Counselors : helps to understand and integrate the meaning of current life
circumstances ,provides guidance and encouragement to make changes
Surrogate : helps to clarify domains of dependence interdependence and
independence and acts on clients behalf as an advocate.
Leader : helps client assume maximum responsibility for meeting treatment goals in
a mutually satisfying way
Orientation Phase
During this phase, the individual has a felt need and seeks professional assistance
The nurse helps the individual to recognize and understand his/ her problem and
determine the need for help
Problem defining phase: identifies problem
Starts when client meets nurse as stranger
Defining problem and deciding type of service needed
Client seeks assistance ,conveys needs ,asks questions, shares preconceptions and
expectations of past experiences
Nurse responds, explains roles to client, helps to identify problems and to use
available resources and services
Activities:
• Nurse and patient come together as strangers;
• Meeting initiated by patient who expresses a “felt need”;
• Work together to recognize,
• Clarify and define facts related to need
Identification Phase
The patient identifies with those who can help him/ her.
The nurse permits exploration of feelings to aid the patient in undergoing illness as
an experience that reorients feelings and strengthens positive forces in the
personality and provides needed satisfaction.
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MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
Teacher’s Insight
Nursing can be a very stressful career and it takes a solid collection of
interpersonal skills to handle the tasks of dealing with patients, their family and 18
friends and other medical personnel.
Nurses are often the first person an injured or ill person interacts with, no matter if
it’s at a medical facility or a Doctor’s office.
It is essential nurse’s arm themselves with the best arsenal of skills to deal with the
Nursing Process
Assessment
Systematic and continuous collection, validation and communication of client data
as compared to what is standard/norm
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MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
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MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
Implementation
To complete nursing actions necessary for accomplishing plan
Reassess client.
Review and modify existing care plan.
Perform nursing actions.
*Nursing actions – directed towards providing for the patient’s immediate
need
Evaluation
To determine extent to which expected outcomes have been achieved.
Nursing students often find that there are multiple correct solutions to a problem.
The key to nursing is to select the “the most correct” solution—one that will be the
most efficient and best fit for that particular situation. You will often find yourself in
situations where there are few “correct” forms of care, but one that is most
appropriate. Using the nursing process, students can narrow down their options
to select the best one.
In her human-to-human relationship model, the nurse and the patient undergoes
the following series of interactional phases:
Original Encounter
This is described as the first impression by the nurse of the sick person and vice-
versa. The nurse and patient see each other in stereotyped or traditional roles.
Emerging Identities
This phase is described by the nurse and patient perceiving each other as unique
individuals. At this time, the link of relationship begins to form.
Empathy
Travelbee proposed that two qualities that enhance the empathy process are
Similarities of experience
the desire to understand another person
This phase is described as the ability to share in the person’s experience. The result
of the empathic process is the ability to expect the behavior of the individual with
whom he or she empathized.
Sympathy
Sympathy happens when the
Nurse wants to lessen the cause of the patient’s suffering.
“When one sympathizes, one is involved but not incapacitated by the
involvement.” The nurse should use a disciplined intellectual approach together with
therapeutic use of self to make helpful nursing actions.
.
Teacher’s Insight
The terms empathy and sympathy are often confused. Although both of the words
deal with the relationship a person has to the feelings and experiences of another
person One is considered to be of more therapeutic than the other.
Both sympathy and empathy have roots in the Greek term páthos meaning
“suffering, feeling.”Sympathy is largely used to convey commiseration, pity, or
feelings of sorrow for someone else who is experiencing misfortune. You feel bad for
them … but you don’t know what it is like to be in their shoes. Empathy on the other
hand is now most often used to refer to the capacity or ability to imagine oneself in
the situation of another, experiencing the emotions, ideas, or opinions of that person.
For the two, empathy is more of therapeutic use than sympathy. Meaning for nurses,
we should be aware that we must understand our patient’s feelings by trying to put 23
our self in their situation to better understand their needs but not to be sympathetic
to their situation in anyway.
MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
Rapport
Rapport is described as nursing interventions that lessens the patient’s suffering.
The nurse and the sick person are relating as human being to human being.
The sick person shows trust and confidence in the nurse. “A nurse is able to
establish rapport because she possesses the necessary knowledge and skills required
to assist ill persons, and because she is able to perceive, respond to, and appreciate
the uniqueness of the ill human being.”
Note that the above stated interactional phases are in consecutive order and
developmentally achieved by the nurse and the patient as their relationship with one
another goes deeper and more therapeutic
D. CONCEPTUAL MODEL/S
X. DOROTHEA OREM
Self Care and Self Deficit Theory
Self-care – is the performance or practice of activities that individuals initiate and
perform on their behalf
– The human’s ability or power to engage in self-care
3 Classifications of Nursing Systems:
- Wholly compensatory – for people who are socially dependent on others
for their existence and well being
- Partly compensatory – both nurse and patient perform care measures
- Supportive – educative – where the nurse is able to perform or can and
should learn to perform required measures of self-care but cannot do so
without assistance
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MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
Born at Los Angeles on October 14, 1939 as the 2nd child of Mr. and Mrs. Fabien
Roy.
At age 14 she began working at a large general hospital, first as a pantry girl, then
as a maid, and finally as a nurse's aid.
She entered the Sisters of Saint Joseph of Carondelet.
she earned a Bachelor of Arts with a major in nursing from Mount St. Mary's College,
Los Angeles in 1963.
a master's degree program in pediatric nursing at the University of California ,Los
Angeles in 1966.
She also earned a master’s & PhD in Sociology in 1973 & 1977 ,respectively
Sr. Callista had the significant opportunity of working with Dorothy E. Johnson
Johnson's work with focusing knowledge for the discipline of nursing convinced Sr.
Callista of the importance of describing the nature of nursing as a service to society
and prompted her to begin developing her model with the goal of nursing being to
promote adaptation.
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MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
ADAPTATION THEORY
Physiologic-Physical Mode
– Behavior pertaining to the physical aspect of the human system
– Physical and chemical processes
– Nurse must be knowledgeable about normal processes
– 5 needs (Oxygenation, Nutrition, Elimination, Activity & Rest, and Protection)
Self Concept-Group Identity Mode
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MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
– The composite of beliefs and feelings held about oneself at a given time. Focus
on the psychological and spiritual aspects of the human system.
– Need to know who one is, so that one can exist with a state of unity, meaning,
and purposefulness of 2 modes (physical self, and personal self)
Role function Mode
– Set of expectations about how a person occupying one position behaves toward a
occupying another position. Basic need-social integrity, the need to know who
one is in relation to others
Interdependence Mode
– Behavior pertaining to interdependent relationships of individuals and groups.
Focus on the close relationships of people and their purpose.
– Each relationship exists for some reason. Involves the willingness and ability to
give to others and accept from others.
– Balance results in feelings of being valued and supported by others. Basic need -
feeling of security in relationships
Reminders: Before proceeding to the exercises, if you have other topics not fully clear to
you, feel free to browse again on the topics and you can also do additional readings from
other textbooks and references. No cheating in the self- assessment exercises. Answer it on
your own without looking at your notes. Good Luck!
REFERENCES:
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MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills Penablanca, Cagayan
COLLEGE OF NURSING
TEXTBOOK:
Nursing Theories and their Works 9th ed, Alligood, 2018
Other References:
1. Theoretical basis for nursing 5th ed. (R) Mcewen 2019
2. Fundamentals of nursing 9th ed. (T) Potter 2017
3. Kozier and Erb's Fundamentals of Nursing: Concepts, Process, and Practice volume 1+
vol 2 (T) Bermam, 2016
4. Kozier & Erb’s Fundamentals of Nursing Concepts, Process and Practice 9th ed. (T)
Berman, A 2014
Journals :
1. American Journal of Nursing
2. Philippine Journal of Nursing Education
3. The Journal for Nurse Practitioners
Website:
1. www.nurseslabs.com
2. medicinenet.com
3. nursing-theory.org
4. www.nursingguide.html
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