FUNDAMENTAL

S OF NURSING
SET 2
NURSING

THEORIES
Nursing Theories
Florence Nightingale

Mother of Modern Nursing

1st Nurse theorist

Environmental Adaptation Theory

-Focused on manipulating the environment to put

patient in best position for nature to act
Nursing Theories
Florence Nightingale
her work in Crimea (1854-1856) earned

her the title “The Lady with the Lamp”.

also known as the First Nurse Scientist

Theorist for her work, Notes on Nursing:
What it is and What it is Not (1860).
Nursing Theories
Virginia Henderson
A nurse, assists the individual, sick or well, in the

performance of those activities contributing to health

or peaceful recovery (peaceful death), that he could
perform unaided if he had necessary will, strength
or knowledge
Nursing Theories
Virginia Henderson
14 Basic Needs of a client
1. Breath normally
2. Eat and drink adequately
3. Eliminate body wastes
4. Move and maintain desirable posture
5. Sleep and rest
6. Select suitable clothes
Nursing Theories
Virginia Henderson
14 Basic Needs of a client
7. Maintain body temperature within normal range by
adjusting clothing or 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
Nursing Theories
Virginia Henderson
14 Basic Needs of a client
10. Communicate with others in expressing
emotions, needs, fears or opinions
11. Worship according to one’s faith
12. Work in such a way that there is a sense of
accomplishment
Nursing Theories
Virginia Henderson
14 Basic Needs of a client
13. Play or participate in various forms of
recreation

14. Learn, discover or satisfy the curiosity that

leads to the normal development and health and
use the available health facility
Nursing Theories
Faye Glenn Abdellah
 Introduced patient-centered
approaches to Nursing model
Twenty-One Nursing Problems
Nursing Theories
Faye Glenn Abdellah

 defined nursing as having a problem-

solving approach, with key nursing
problems related to health needs of
people.
 Nursing Theories
Faye Glenn Abdellah

She also defined nursing as a service to

individual and families; therefore the society.

Crucial in nursing practice is the correct

identification of nursing problems:
a. OVERT : apparent conditions
b. COVERT: hidden conditions
Nursing Theories
Dorothy Johnson Conceptualized
Behavioral System Model
7 subsystems:
1. Ingestive 5. dependence
2. Eliminative 6. achievement
3. affiliative, 7. sexual & role identity
4. Aggressive
behavior
Nursing Theories
Hildegard Peplau
 Introduced the Theory of Interpersonal
Relations
 4 phases:

1. Orientation
2. Identification
3. Exploitation
4. Resolution
Nursing Theories
 Myra Levine’s Adaptation-Conservation
Theory

 She advocated that nursing is a human

interaction and proposed

 4 conservation principles of nursing which are

concerned with the unity and integrity of the
individual.
Nursing Theories
 Myra Levine’s Adaptation-
Conservation Theory
 Described 4 conservation principles
1. Conservation of Energy
2. Conservation of Structural Integrity
3. Conservation of Personal Integrity
4. Conservation of Social Integrity
Nursing Theories
Jean Watson
 Conceptualized : Theory of Human Caring

 Believed that nursing is the application of the art &

human science through transpersonal caring
transactions

 Asserted that caring stance is threatened by the

tasks and technology demands of the curative
factors
 Nursing Theories

 Madeleine Leininger

 Theory of Cultural Care, Diversity and

Universality
 (Transcultural Nursing Model )
 Nursing Theories
 Dorothea Orem
 Developed the Self-Care and Self-Care
Deficit Theory
 Conceptualized 3 nursing systems: wholly
compensatory, partially compensatory,
supportive-educative
Nursing Theories
Martha Rogers
 Conceptualized the Science of Unitary

Human Beings
 Believed that human beings have the

capacity for abstraction, imagery,

language, thought, sensation, & emotion
Nursing Theories
Martha Rogers
- The theorist whose theory can be defined
as the development of a science of
humankind, incorporating the concepts of
energy fields, openness pattern and
organization
Nursing Theories
Lydia Hall ( Core, Care, and Cure Model)
 Explained the:
1.Care(nurturance; exclusive to nursing)
2.Core (therapeutic use of self)
3.Cure(related to physician’s orders)
components
Nursing Theories
Sister Callista Roy
 Presented the Adaptation Model
 Viewed person as unified biopsychosocial system

 OPEN system theory

 The theorist who believes that adaptation and
manipulation of stressors are needed to foster change
Nursing Theories

Rosemarie Rizzo Parse

 Introduced the Theory of Human Becoming

 Individual makes his/her own personal choice

 Health Care Delivery Systems: Levels
of Prevention by Leavell & Clark

 Primary Care/Prevention
 Health Promotion/Preventive Care
 Quit smoking
 Avoid/limit alcohol intake
 Regular exercise
 Well-balanced diet
 Adequate fluids
 Complete immunization program
 Safety/accident prevention measures
 Health Care Delivery Systems
 Secondary Care/Prevention
 Early detection & treatment
 Surgery and services by specialist
 Annual physical exam
 Regular pap smear
 Monthly BSE for women who are
 20 years old & above
 Sputum exam for TB
 Annual guaiac & rectal exam for clients over 50 years
Tertiary Care/Prevention
Restoration & Rehabilitation
Self-monitoring of blood glucose among

diabetics
Physical therapy after CVA, cardiac rehabilitation

post-MI
Speech therapy after laryngectomy

Attending self-management education for DM

MAN and His Basic Human Needs

CONCEPT OF MAN
ATOMISTIC APPROACH

The atomistic study of man views man as an

organism composed of different organ
systems where each system is composed of
organs and each organ is composed of
tissues and cells.
HOLISTIC APPROACH

 This view traces man’s relationship with other

human beings in the suprasystem of society.
This approach views man as a whole organism
with interrelated and interdependent parts
functioning to produce behavior.
HOLISTIC APPROACH

 Man as a whole therefore is different from

and more than the sum of his component
parts. The dimensions of man include the
physical, social, spiritual, cognitive and
psychological aspects.
 Man as a social being is capable of
relating with others. His first agent of
socialization is the family where he is
nurtured, where he learns his first
language and where he first learns to
socialize.
 Man as a spiritual being is capable of such
virtues as faith, hope and charity. Faith is
the unquestioning belief in someone or
something. It is the foundation where hope
rests.
 Charity means the love of man for his fellowmen. Man as
a spiritual being believes in a power beyond himself and
of transcending one’s limitations.
 Man as a thinking being is capable of perception,
cognition, and communication. He is also capable of
logical thinking and reasoning.
Man as a psychological being is capable of
rationality. His rational side makes him merciful,
kind and compassionate.

Man as a physical being has such characteristics

as genetic endowment, sex, other physical
attributes, physical structure and functions.
Abraham Maslow’s Hierarchy of Basic
Human Needs

NEED - is something that is essential to the

survival of humans.
A basic need is something whose:
1. Absence may lead to illness
2. Presence may signal health or prevent illness
3. If unmet needs are met or fulfilled, health may
be restored
FIRST LEVEL: Physiological Needs

a. Oxygen f. Shelter
b. Fluids g. Rest
c. Nutrition h. Sex
d. Temperature
e. Elimination
SECOND LEVEL: Safety and Security Needs

 1. Physical Safety: - involves reducing or

eliminating threats to the body such as illness,
accident and environmental exposure.

 2. Psychological Safety : - understanding and

the appropriateness of what to expect from
others, from new experiences and from
encounters with the environment.
THIRD LEVEL

 Love and Belonging Needs - need to

establish social relationships and to
experience emotional nurturance and care
to and from others.
FOURTH LEVEL:
Esteem and Self-Esteem Needs - linked
with the desire for strength, achievement,
adequacy, competence, confidence, and
independence.
 FIFTH LEVEL: Need for Self-
Actualization - highest level of all
needs.

Characteristics of a self-actualized individual:

1.Solves own problems.

2.Assists others in problem-solving.

3.Accepts suggestions of others.

4.Has broad interest in work and social topics.

Characteristics of a self-actualized individual:

5.Possesses good communication skills as a

listener and communicator.
6.Manages stress and assists others in managing
stress.
7.Enjoys privacy.
Characteristics of a self-actualized individual:

8. Seeks new experiences and knowledge.

9. Shows confidence in abilities and decisions.
10. Anticipates problems and successes.
12. Likes self.
Characteristics of Basic Human Needs:

1. Needs are universal

2. Needs may be met in different ways.
3. Needs may be stimulated by external and
internal factors.
4. Priorities may be altered.
5. Needs may be deferred.
6. Needs are interrelated.
HEALTH and ILLNESS

 CONCEPT OF HEALTH,
WELLNESS, WELL-
BEING AND ILLNESS
HEALTH

 is the fundamental right of every

human being. It is the state of
integration of the body and mind.
Health is the ability to maintain

dynamic equilibrium (Selye)

Health and Illness
World Health Organization
 Complete physical, mental, & social well-being,

& not merely the absence of disease

Claude Bernard
 Ability to maintain internal milieu
Health and Illness
Walter Cannon- Theory of Health
 Ability to maintain homeostasis or equilibrium

Concept of Wellness
 Well-being, a choice, way of life, integration of

mind, body & spirit, & loving acceptance of

oneself
Different Dimensions of Wellness :

 1. Physical - the ability to carry-out daily tasks

(grooming, mobility, etc.) and to achieve fitness
of the different organ systems of the body.

 2. Emotional - the ability to manage stress and

to express emotions appropriately.
Different Dimensions of Wellness :

 3. Social - ability to interact successfully with

people and within the environment of which each
person is a part, to develop and maintain
intimacy with significant others and to develop
respect and tolerance for those with different
beliefs.
Different Dimensions of Wellness

4. Intellectual - the ability to learn and use

information effectively for personal, family, and
career development.

5. Spiritual - the belief in some force (nature,

science, religion, or a higher power) that serves to
unite human beings and provide meaning and
purpose of life.
Different Dimensions of Wellness
 6. Occupational - ability to achieve
balance between work and leisure time.
HEALTH-ILLNESS CONTINUA DUNN’S
HIGH-LEVEL WELLNESS GRID

 - A health grid in which the health axis and the

environment axis intersect to demonstrate
interaction. The health axis extends from peak
wellness to death and the environmental axis
extends from very favorable to very unfavorable.
The intersection forms four health/wellness
quadrants:
HEALTH-ILLNESS CONTINUUM DUNN’S HIGH-
LEVEL WELLNESS GRID
HEALTH-ILLNESS CONTINUUM DUNN’S HIGH-
LEVEL WELLNESS GRID
Health Belief Model (HBM) Becker, 1975

 Relationship between person’s belief &

behavior
 Individual perceptions & modifying factors

may influence health beliefs & preventive

health behavior
Smith’s Model of Health
 Clinical Model: narrowest interpretation
Health: freedom from disease
Illness: presence of disease

 Adaptive: ability to adapt to social, mental &

physiologic changes
Smith’s Model of Health

 Role Performance: ability to fill societal

role (family, work)

 Eudaemonistic: most holistic &

comprehensive; actualization of potentials
Models ofHealth and Illness

Leavell & Clark’s Agent-Host-Environment

Model (Ecologic Model)
This model has three dynamic interactive
elements:
1.Agent : any environmental factor or stressor
(biologic, chemical, mechanical, physical, and
psychological) whose presence or absence can
lead to illness or death
Models of Health and Illness

2. Host : person(s) who may or may not be at risk

of acquiring a disease based on family history of
disease, lifestyle habits and age

3. Environment : all factors external to the host

that may or may not predispose the person to the
development of disease
Models ofHealth and Illness

 Health Promotion Model (Nola J. Pender,

1982, 1993, 1996)
 Directed at increasing level of well-being & self-
actualization: improved quality of life, with
healthy lifestyles, & having self-responsibility
Illness
 Personal state where a person feels unhealthy
 Diminished physical, emotional, intellectual, social,
developmental or spiritual functioning
 Not synonymous with disease
 Disease is an alteration of body functions: reduction of
capacities & shortening of normal life span
Disease and Illness Disease

 In other words: Disease is an illness with

objective facts while Illness is a subjective
perception of not being well.
Stages of Illness:

Stage 1. Symptoms Experience - experience

some symptoms, persons believes something is
wrong. 3 aspects – physical, cognitive and
emotional.

Stage 2. Assumption of the Sick Role -

acceptance of illness, seeks advice.
Stages of Illness:

Stage 3. Medical Care Contact - seeks

advice to professionals for validation of real
illness, explanation of symptoms,
reassurance or predict of outcome.
Stages of Illness:

 Stage 4. Dependent Patient Role - the person becomes a

client dependent on the health professional for help;
accepts or rejects health professional’s suggestions;
becomes more passive and accepting.

 Stage 5. Recovery/Rehabilitation - gives up the sick role

and returns to former roles and functions.
Classification of Diseases:

1. According to Etiologic Factors:

A. Hereditary – due to defect in the genes of one

or other parent which is transmitted to the
offspring.

B. Congenital – due to defect in the development,

hereditary factors or prenatal infection
Classification of Diseases:

C. Metabolic – due to disturbance or abnormality in

the intricate processes of metabolism

D. Deficiency – results from inadequate intake or

absorption of essential dietary factor

E. Traumatic – due to injury

Classification of Diseases:

F. Allergic – due to abnormal response of

the body to chemical and protein
substances or to physical stimuli

G. Neoplastic – due to abnormal or

uncontrolled growth of cell
Classification of Diseases:

H. Idiopathic – cause is unknown; self-originated;

of spontaneous origin
I. Degenerative – results from the degenerative
changes that occur in the tissues and organs

J. Iatrogenic – result from the treatment of the

disease
According to Duration or Onset:

A. Acute Illness – has short duration and is

severe. Signs and symptoms appear
abruptly, intense, and often subside after
a relatively short period.
According to Duration or Onset:
B. Chronic Illness – usually longer than 6 months, and can
also affect functioning in any dimension.
Is characterized by:
 Remission – periods during which the disease is
controlled and symptoms are not obvious.
 Exacerbations – disease becomes more active given
at a future time, with recurrence of pronounced
symptoms.
 Sub-Acute – symptoms are pronounced but more
prolonged than the acute disease
Disease may also be described as:

A. Organic
B. Functional
C. Occupational
D. Venereal
Disease may also be described as:

E. Familial
F. Epidemic
G. Endemic
H. Pandemic
I. Sporadic
Risk Factors of a Disease:

1. Genetic or Physiologic - genetic predisposition.

2. Age - increase or decrease client’s susceptibility

to acquire disease.

3. Environment - surroundings that can affect the

person.
Risk Factors of a Disease:

4. Lifestyle - habits that increases the chance of

acquiring a disease.

5. Sex - gender