History of the theorist y y Faye Glenn Abdellah was born in new York city.

She began her nursing career in 1942 when she received her diploma in nursing from Fitkin memorial school of nursing in Neptune. In 1945,she received her BS ,in1947 her MA and in 1955 her EdD from teachers college,columbia university, New York city. She appointed as chief nursing officer of the united states public health service in 1970 and as concurrent deputy surgeon general in 1982,she retired in 1989 She used the problem solving approach as the basis for her typology. Her typology of nursing problems was first published in1960 in patient-centered approaches to nursing. In 1973,she refined some of her beliefs about nursing Concepts used by abdellah 1.NURSING(service to individual) Acc to her, nursing is based on an art and science that mould the attitudes, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help people, sick or well, cope with their health needs and may be carried out under general or specific medical direction. 2.HEALTH a) Health is dynamic pattern of functioning there is a continued interaction with the internal and external forces, that result in the optimal use of necessary resources that serve to minimize vulnerabilities. b) Emphasis should be placed upon prevention and rehabilitation. c) Performing Nsg services through a holistic approach to the client 3.NURSING PROBLEMS a) Nursing problem presented by a client is a condition faced by the client or client s family that the nurse through the performance .The problem can be either an overt or covert nursing problem. b) An overt nursing problem is an apparent condition faced by the patient or family, which the nurse can assist him or them to meet through the performance of her professional functions.

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c) The covert nursing problem is a concealed or hidden condition faced, by the patient or family, which the nurse can assist him or them to meet through the performance of her professional functions d) The identification and classification of problems was called the typology of nursing problems. y y Abdellah typology was divided into three areas 1.The physical ,sociological and emotional needs of the patient.
Vitamin acceptance Awareness of self Therapeutic environment spirtuality Interpersonal relationship communicatio n Emotions and illness interrelationship s Feelings and reactions Sensory functions regulatory mechanism 21 NURSI NG PROBL EMS Resource to resolve problem Role of social problem in illness Hygiene and physical comfort Activity and rest Safety

Body mechanics

oxygenation Nutrition

Elimination Fluid and electrolyte Response to disease

ABDELLAH S THEORY AND THE FOUR MAJOR CONCEPTS 1.NURSING a) Nursing is a helping profession. In Abdellah s model, nursing care is doing something to or for the person or providing information to the person with the goals of meeting needs, increasing or restoring self-help ability, or alleviating impairment. b) Nursing is broadly grouped into the 21 problem areas to guide care and promote use of nursing judgment. c) She considers nursing to be comprehensive service that is based on art and science and aims to help people, sick or well, cope with their health needs. 2. Person a) Is the recipient of nursing care b) A being having physical ,emotional and sociological needs

c) Include families as well as individuals d) Is capable of learning and of self help of varying degrees Typology and nursing problem is said to be evolve from the recognition of a need for patient centered approach to nursing. 3.Environmenta) Environment is least discussed concept in her model b) She also states that if nurses reaction to the patient is hostile or negative ,the atmosphere in the room may be hostile or negative. 4.Health a) Is not specifically defined by abdellah ,but she refers to health needs and a healthy state of mind and body .The client s continued health is the purpose of nursing. b) Is viewed as a state that exclude illness c) Can also be described as a state in which the person has no unmet need and not anticipated or actual impairment. 1.ASSESSMENT PHASE y y Nursing problems provide guidelines for the collection of data. A principle underlying the problem solving approach is that for each identified problem, pertinent data are collected. The overt or covert nature of the problems necessitates a direct or indirect approach, respectively. 2. y y y NURSING DIAGNOSIS

The results of data collection would determine the client s specific overt or covert problems. These specific problems would be grouped under one or more of the broader nursing problems. This step is consistent with that involved in nursing diagnosis 3. PLANNING PHASE

The statements of nursing problems most closely resemble goal statements. Therefore, once the problem has been diagnosed, the Given that these problems are called nursing problems, then it becomes reasonable to conclude that these goals are basically nursing goals. 4. IMPLEMENTATION

Using the goals as the framework, a plan is developed and appropriate nursing interventions are determined. 5. EVALUATION

According to the American Nurses Association Standards of Nursing Practice, the plan is evaluated in terms of the client s progress or lack of progress toward the achievement of the stated goals. This would be extremely difficult if not impossible to do for Abdellah s nursing problem approach since it has been determined that the goals are nursing goals, not the client goals. Thus, the most appropriate evaluation would be the nurse progress or lack of progress toward the achievement of the LIMITATIONS Very strong nursing centered orientation Little emphasis on what the client is to achieve Her framework is inconsistent with the concept of holism Potential problems might be overlooked DELIMITATIONS The patient centered approach was constructed to be useful to nursing practice, with impetus for it being nursing education. Abdellah s publications on nursing education began with her dissertation; her interest in education for nurses continues into the present. Abdellah has also published on nursing, nursing research, and public policy related to nursing in several international publications. She has been a strong advocate for improving nursing practice through nursing research

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Application of Abdellah s theory Mrs. Mary James is a forty two years old women admitted in ICU after Road side accident having head injury and altered level of consciousness

pt s need 1.Hygiene and physical discomfort 2.Activity and rest 3.Safety

nursing diagnosis

Nursing interventions

4.Body mechanics

5.oxygenation

1.Impaired oral mucous 1.Mouth care with membrane r/t to absence of kMno4*2hrly given pharyngeal ref lex and altered fluid intake 1.Side rails provided to the 3.Risk of injury r/t to patient prevent fallings decreased level of 2.Clean dry and wrinkle free consciousness bed to prevent bed sores 1.Passive exercises of legs and arms done 4.Impaired physical mobility 2.2hrly position changing r/t to prolonged bed rest or ALOC 1.2hrly suctioning done 5.Ineffective airway clearance 2.Nebulization done *4hrly related to ALOC 6.Impaired nutrition status r/t to metabolic changes and inadequate intake 7.Impaired urinary elimination pattern r/t to incontinence or retention 8.Deficient fluid volume r/t to inability to take in fluids by 1.NG feeding *2 hrly

6.Nutrition

7.Elimination

8.Fluid and electrolyte

1.Catheterization is done 2.Catheter care provided *2 hrly 1.Hydration status of pt is assessed by skin turgor
2.Maintain intake and output chart

9.Response to disease 10.Regulatory mechanism

11.Sensory functions 12.Feeling and reactions 13.Emotions and illness relationship 14.Communication 15.Interpersonal relationship 16.Spirituality 17.Therapeutic environment 18.Awareness of self 19.Vitamin acceptance 20.Resource to resolve problem 21.Role of social problem in illness

10.Ineffective thermoregulation r/t to damage to hypothalamic center 11.Disturbed sensory perception r/t to neurologic impairment

1.TPR checked * 2 hrly 2.BP checked*2 hrly

1.Orients the pt to time place at least once every 8 hrs 2.Touch the pt and spends enough time with pt.

Not applicable to the pt Not applicable to the pt Interrupted health process r/t to health crisis

1.Clarify information about the pt s condition to relatives

pt s need 1.Hygiene and physical discomfort 2.Activity and rest 3.Safety 4.Body mechanics 5.oxygenation 6.Nutrition 7.Elimination 8.Fluid and electrolyte 9.Response to disease

nursing diagnosis 1.Impaired oral mucous membrane r/t to absence of pharyngeal reflex and altered fluid intake 3.Risk of injury r/t to decreased level of consciousness 4.Impaired physical mobility r/t to prolonged bed rest or ALOC 5.Ineffective airway clearance related to ALOC 6.Impaired nutrition status r/t to metabolic changes and inadequate intake 7.Impaired urinary elimination pattern r/t to incontinence or retention 8.Deficient fluid volume r/t to inability to take in fluids by mouth

Nursing intervention

1.Mouth care with kMn 1.Side rails provided to fallings 2.Clean dry and wrinkl bed sores 1.Passive exercises of le 2.2hrly position changi 1.2hrly suctioning done 2.Nebulization done *4 1.NG feeding *2 hrly 1.Catheterization is don 2.Catheter care provide 1.Hydration status of pt turgor 2.Maintain intake and