NEEDS THEORY

“The nurse is temporarily the conscious of

the unconscious, the love of life for the
suicidal, the leg of the amputee, the eyes of
the newly blind, a means of locomotion for
the infant, knowledge and confidence for
the mother, the multipiece for those too
weak or withdrawn to speak and so on”

WEEK 10 C. NURSING THEORIES

VIRGINA HENDERSON
(1897-1996)
 First Lady of Nursing
 First International Nurse
 Full-time instructor in Virginia
 Advocate for the introduction of psychiatric nursing
 Outstanding teacher
 Published a Book: Nature of Nursing
 Selected as American Nurses Association Hall of
Fame
 The Sigma Theta Tau Library was named after her
 One of the 51 Pioneer Nurses in Virginia
 Considered the 20th Century Nurse
METAPARADIGM IN NURSING
NURSING PERSON
 Nurses must promote the  the client that requires
treatment plan prescribed by assistance to achieve
the physician. She must act health and independence
independently. Care must and in some cases, a
include all walks of life, from peaceful death. The person
well to sick, from the must function to the utmost
newborn to dying. This by maintaining
definition was considered physiological and emotional
the “signature” of nursing. balance.
METAPARADIGM IN NURSING
HEALTH ENVIRONMENT
 quality of life. It is  healthy individuals
influenced by should control the
external and internal environment but if
factors. Health
there is illness, this
promotion is more
important than the ability is affected
care of the sick. or diminished.
THE NURSE-PATIENT RELATIONSHIP

WEEK 10  The nurse as a substitute for

the client
 The nurse as a helper to the
client
 The nurse as a partner with the
patient
THE NURSE-PHYSICIAN
RELATIONSHIP

WEEK 10
 Henderson asserts that nurses function
independently from physicians. She
insisted that nurses do not follow
doctor’s orders; rather they follow in a
philosophy that allows physicians to
give orders to clients. She said that
many nursing roles and responsibilities
overlap with that those of the
physicians.
NURSE AS A MEMBER OF
HEALTHCARE TEAM

WEEK 10  Henderson mentioned that

every member must work
independently for the team to
work in harmony. The nurse
should work and contribute in
carrying out the total program
of care.
ACCEPTANCE BY THE NURSING
COMMUNITY
PRACTICE RESEARCH
 Henderson’s approach  She supported the use
focuses on decision-making of research in
and is deliberate in such a
way that in every step of improving the practice
the nursing process. of nursing. Various
 Assessment Phase research questions
 Planning Phase arise commonly from
 Implementation Phase her 14 basic needs.
 Evaluation Phase
EDUCATION
A. First Phase- the emphasis is made on helping the client
perform activities of daily living.
B. Second Phase- importance is placed on assisting
clients to achieve their needs in times of marked body
disturbances or illness. In here, the student understands
the rationale behind the prescribed therapeutic plans
made by the physician.
C. Third Phase- centered on the client and his family
together with the dynamics affecting the relationship
inside the unit.
THEORY ANALYSIS
CLARITY SIMPLICITY
 Her theory has no  Her concept of
structural form or nursing is
diagram but her 14
complex. The 14
basic needs are
clearly defined and basic needs had
consistent with her several revisions
theory. to make them
concise.
THEORY ANALYSIS
GENERALITY ACCESSIBILITY
Henderson’s theory is used
Her definitions


in practice and the concepts
are broad in are clinically significant as
they are focused on
scope. This could assisting individuals to gain
cover all areas of independence in relation to
the performance of
nursing practice. activities contributing to
health or its recovery.
THEORY ANALYSIS
IMPORTANCE
 The perspective related to
Henderson’s theory opened doors
for development by the upcoming
nursing theorists. Her definition of
the unique function of a nurse has
been widely read and accepted.
 HUMAN
RELATIONSHIP
MODEL
“ A nurse does not seek to alleviate
physical pain or render physical care-
she ministers to the whole person. The
existence of suffering, whether
physical, mental or spiritual is the
proper concern of the nurse.”

WEEK 10 C. NURSING
JOYCE TRAVELBEE (1926-
1973)
 Psychiatric Nurse
 She died at the age of 47 and was
not able to finish her doctorate
degree.
 Instructor in Psychiatric Nursing
 She published various articles
and journals
 She published a book entitled “
Interpersonal Aspects of Nursing
in 1996 and 1971.
METAPARADIGM IN
NURSING
NURSING PERSON
 an interpersonal process  defined as a human
whereby the professional being (nurse and
nurse practitioner assists an
patient). The human
individual, family, or
community to prevent or being is unique, an
cope with the experience of irreplaceable individual
illness and suffering and to who is in the continuous
find meaning in these process of becoming,
experiences. evolving, and changing.
METAPARADIGM IN
NURSING
HEALTH ENVIRONMENT
 it is measured by  was not clearly defined in
subjective and objective her theory. Human
health. Subjective is the conditions and life
person’s well-being in experiences encountered
accord with self- by all men as suffering,
appraisal of physical- hope, pain, and illness
emotional-spiritual which are all associated
status. with the environment.
HUMAN-TO-HUMAN RELATIONSHIP
MODEL
PATIENT AND NURSE
INTERACTIONAL PHASES
Original Emerging
Encounter Identities
described as the first  Nurse and
impression by the nurse
of the sick person and patients perceive
vice-versa. The nurse each other as
and the patient see unique
each other in
stereotyped or individuals. This
traditional roles. time the
relationship
PATIENT AND NURSE
INTERACTIONAL PHASES
Empathy Sympathy
 this is the ability to  It happens when
share in the person’s
experience. The result of the nurse wants
this is the ability to to lessen the
expect the behavior of cause of the
the individual with
whom he or she client’s suffering.
emphasized
PATIENT AND NURSE
INTERACTIONAL PHASES
Rapport
 Nursing interventions
that lessen the client’s
suffering. The sick
person shows trust and
confidence in the nurse.
Acceptance by the Nursing
Community
The hospice is one good example
in which her theory is applied. The
hospice nurse attempts to build
Practice rapport or a working relationship
with the client as well as her
significant
her concepts process.
served as better
assistance for nurses who help
individuals understand the
Education meaning of illness and
suffering.
numerous sources in
research studies have cited
some aspects to one-to-one
Research
relationship projected by
Travelbee.
 THEORY ANALYSIS
CLARIT SIMPLICI GENERALI ACCESSIBIL IMPORTAN
Y TY TY ITY CE
•her definitions
are not
•her •her theory •It is useful
has a wide because it
consistent in theory scope of
•her theory
clarity and
origin. Some of contains application. It appears to can
her definitions
different is applicable have a low describe,
were lifted from whenever measure of explain,
standard variables, the nurse empirical
sources predict
(Webster’s so her encounters soundness, and
Dictionary). She theory is clients in
as it lacks control
also used distress and
different terms not life-changing simplicity. phenomen
with the same
definitions. simple. events. a.
DELIBERATIVE NURSING PROCESS
“Nursing THEORY
is responsive to
individuals who suffer or anticipate
a sense of helplessness; it is
focused on the process of care in
an immediate experience; it is
concerned with providing direct
assistance to individuals in
whatever setting they are found,
for the purpose of avoiding,
relieving,10
WEEK diminishing
C.or NURSING
curing the THEORIES
individual’s sense of helplessness”
IDA JEAN ORLANDO-
PELLETIER(1926-2007
 Associate Professor
 Director of the Graduate Program in
Mental Health Psychiatric Nursing
 Project Investigator of a National
Mental Health Psychiatric Nursing
 Director of a Research Project
 Board Member of Harvard
Community Health Plan
METAPARADIGM IN NURSING
Nursing- Person- Health- it is
replaced by a
unique and she used Environ sense of
independent the ment- helplessness
in its concept of as the
concerns for she initiator of a
human for
an
persons.
disregard necessity for
individual’s nursing. She
Humans ed this in stated that
need for
help in an are the her nursing deals
immediate focus of theory with
individuals
situation nursing who are in
practice need of help
DELIBERATIVE NURSING PROCESS
THEORY
 Nurse should converse with the client and let them
know what the plan of care for the day is going to be.
 However, regardless of how well thought out a nursing
care plan is for a client, unexpected problems to the
client’s recovery may arise at any time.
 With these, the job of the nurse is to know how to deal
with those problems so the client can continue to get
back and reclaim his or her well-being.
Assumptions of Ida Jean Orlando
1. When patients cannot cope with their needs on their
own, they become distressed by feelings of
helplessness.
2. In its professional character, nursing adds to the
distress of the patient.
3. Patients are unique and individual in how they
respond.
4. Nursing offers mothering and nursing analogous to
an adult who mothers and nurtures a child.

5. The practice of nursing deals with people, the

environment, and health.
Assumptions of Ida Jean Orlando
6. Patients need help communicating their needs; they
are uncomfortable and ambivalent about their
dependency needs.
7. People can be secretive or explicit about their
needs, perceptions, thoughts, and feelings.
8. The nurse-patient situation is dynamic; actions and
reactions are influenced by both the nurse and the
patient.
9. People attach meanings to situations and actions
that aren’t apparent to others.
10. Patients enter into nursing care through medicine.
Assumptions of Ida Jean Orlando
11. The patient cannot state the nature and meaning
of his or her distress without the nurse’s help or him
or her first having established a helpful relationship
with the patient.
12. Any observation shared and observed with the
patient is immediately helpful in ascertaining and
meeting his or her need or finding out that he or she is
not in need at that time.
13. Nurses are concerned with the needs the patient is
unable to meet on his or her own.
 STAGES OF THE DELIBERATIVE
NURSING PROCESS
• the nurse completes a holistic
Assessment assessment of the client’s needs. She
uses objective and objective data
• the nurse uses the nurse clinical
Diagnosis judgment about health problems
• it addresses each of the problems
Planning identified in the diagnosis

• the nurse uses the Nursing Care

Implementation Plan

Evaluation •the nurse investigates the progress of the client towards the goals set in
the nursing care plans
 ACCEPTANCE BY THE
COMMUNITY

Practice Education Research

•her process of •her theory has
•very easy to been applied in
recording has
understand, made a various research
settings. She
easy to use, significant focused on how to
and focuses contribution to produce
facilitating self- improvement in the
on the client. evaluation. client’s behavior.
 THEORY ANALYSIS
Accessibili Importanc
Clarity Simplicity Generality
ty e
•clear as •simple as •focus •it •benefi
it it can
predict es on benefit cial in
involves statements ed achievi
defining as opposed limite
concept to resear ng
description d ch valued
s
minimal
and
explanatio
situat applica outco
ly. n ions tion mes
 TWENTY-ONE
NURSING PROBLEMS
“ I never wanted to be a
medical doctor because I could
do all I wanted to do in nursing,
which is a caring profession”

WEEK 10 C. NURSING THEORIES

FAYE GLENN ABDELLAH
 First woman and first nurse to serve as
Deputy Surgeon General of the US.
 Inducted into the US National Woman’s
Hall of Fame
 Fellow, American Academy of Nursing
 She contributed 100 publications related
to nursing care, education, nursing
research, and advance nursing practice.
 Promoted client-centered all-inclusive
nursing care making nursing a true
humanitarian service to individuals
The concept of nursing as an art
and a science molds the attitude,
intellectual competencies, and
technical skills of the individual
nurse into the desire and ability to
help individuals cope with their
needs.
As a complete humanitarian
service, Nursing includes the
following:
 Be acquainted with the nursing problems
of the client
 Choose the definite courses of action to
make in the scope of relevant nursing
principles
 Make available continuous care of the
individual’s entire health needs
As a complete humanitarian
service, Nursing includes the
following:
 Give continuous care to relieve pain and
discomfort and provide immediate security for
the individual
 Regulate the total nursing care plan to meet
the client’s entire health needs
 Serving the individual to become more self-
determining in achieving maintaining a healthy
state of mind and body
As a complete humanitarian
service, Nursing includes the
following:
 Informing the nursing personnel, family
and support system to provide the
individual act for oneself within
perceived limitations
 Facilitate the individual to adapt to limits
and emotional problems
As a complete humanitarian
service, Nursing includes the
following:
 Team up with different allied health
professions in working with the diagram for
optimum health on local, state, national, and
international levels
 Engaging in non-stop evaluation and
research to develop nursing techniques and
create new techniques to serve the health
needs of different people
METAPARADIGM IN
NURSING
ENVIRONME
NURSING PERSON HEALTH NT
•the concept of •she classifies •it is defined as the •the idea of
center and purpose Environment is
nursing in this the beneficiary of nursing services.
theory is of care as She does not give a
addressed by
individuals. definition of health; Abdellah and is
generally
she speaks to “total included in
grouped into 21 However, she
health needs” and “planning for
problem areas does not set a “healthy state of optimum health
for nurses to standard limits mind and body” in
on local, state,
work out their on the nature her description of
national, and
judgment and nursing as a
and essence of comprehensive international
appropriate. human beings. service. levels.
TYPOLOGY OF 21 NURSING
PROBLEMS
 1. To maintain good hygiene and physical comfort.
 2. To promote optimal activity: exercise, rest, sleep
 3. To promote safety by preventing accidents,
injuries, or other trauma and preventing the
spread of infection.
 4. To maintain good body mechanics and prevent
and correct the deformity.
TYPOLOGY OF 21 NURSING
PROBLEMS
 5. To facilitate the maintenance of a supply of
oxygen to all body cells.
 6. To facilitate the maintenance of nutrition for
all body cells.
 7. To facilitate the maintenance of elimination.
 8. To facilitate the maintenance of fluid and
electrolyte balance.
TYPOLOGY OF 21 NURSING
PROBLEMS
 9. To recognize the physiologic responses of the body
to disease conditions—pathologic, physiologic, and
compensatory.
 10. To facilitate the maintenance of regulatory
mechanisms and functions.
 11. To facilitate the maintenance of sensory function.
 12. To identify and accept positive and negative
expressions, feelings, and reactions.
TYPOLOGY OF 21 NURSING
PROBLEMS
 13. To identify and accept the interrelatedness of
emotions and organic illness.
 14. To facilitate the maintenance of effective verbal and
nonverbal communication.
 15. To promote the development of productive
interpersonal relationships.
 16. To facilitate progress toward achievement and
personal spiritual goals.
 17. To create or maintain a therapeutic environment.
TYPOLOGY OF 21 NURSING
PROBLEMS
 18. To facilitate awareness of self as an individual with
varying physical, emotional, and developmental
needs.
 19. To accept the optimum possible goals in the light
of limitations, physical and emotional.
 20. To use community resources as an aid in resolving
problems that arise from an illness.
 21. To understand the role of social problems as
influencing factors in the cause of illness.
The Problem-Solving Approach
Revis
Se Se De Test
ing
ing
lec lec vi hyp
hypot
heses
tin tin si oth when
neces
Iden eses
g g sary,
tifyi ng thro on
ng rel rel ugh the
the
ev ev hy the
basis
of
prob ass
lem an an po ort
concl
usion

t t th men
s
obtai
t of ned
da da es dat from
the
a
ta ta es data.
ACCEPTANCE BY THE NURSING
COMMUNITY
•the typology of twenty-one nursing problems helps

Practice nurses and nursing students perform in a scientific

and systematic way

•the typology of twenty-one nursing problems had

Education the most potent effect in the educational system

•the typology of twenty-one nursing problems produced

Research through research therefore, it is expected that more research

followed after its introduction to the academic world.
THEORY ANALYSIS
Accessibili Importanc
Clarity Simplicity Generality
ty e
• the •the •the •the
typolog typology of importance
• all terms concepts on problem-
y is 21- Nursing
are are very solving is not
Problems
consistent straightf are exact with restricted by
and easy time or space
orward collective empirical
to and gives a
understan and is and referents way for
d and are practica associated that are continual
all nursing l to use with time easily growth and
related and change in the
among recogniza service of
environmen
clients ble nursing care.
t