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Compilation of Nursing Theorists

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COMPILATION OF NURSING THEORISTS Bicol University Polangui Campus Polangui, Albay S.Y. 2010 - 2011 Prepared By: BS Nursing 1 Mrs. Daisy Lorilla Professor
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Page 1: Compilation of Nursing Theorists

COMPILATION OFNURSING THEORISTS

Bicol University Polangui CampusPolangui, AlbayS.Y. 2010 - 2011

Prepared By:

BS Nursing 1

Mrs. Daisy Lorilla

Professor

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Florence Nightingale

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Florence Nightingale – Environmental Theory

Born: May 12, 1820 Birthplace: Florence, Italy Died: August 13, 1910 at Great Britain at the ripe age of 90Best Known As: British nursing hero of the Crimean War (Lady with the Lamp)

• February 7, 1837 Florence Nightingale heard the voice of God telling her that she had a mission in life.• August 1853 she started work herself as the superintendent of the recently-opened Hospital for Invalid Gentlewomen in London.• March of 1854 brought the start of the Crimean War, with Britain, France and Turkey declaring war on Russia.• 1860 Florence Nightingale started the first nursing school at St. Thomas' Hospital in London. This school laid the foundation of professional nursing.• 1861, she helped inspire the Liverpool system of district nursing, which later spread widely. work in the Crimea. • In the Crimea she became ill with Crimean Fever and was invalid from 1858-1888 due to her debilitating and excruciating symptoms• 1901, Florence Nightingale was completely blind.• 1907 she was awarded the Order of Merit by King Edward VII.• In 1908 was given the Honorary Freedom of the City of London.

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Metaparadigm in Nursing

NursingNightingale had always considered that nursing is very essential for

everybody’s being.

PersonNightingale viewed the essence of a person as patient. She believed

that nurses should perform task to and for the patient as well as control the patient’s environment to facilitate easy recovery.

HealthNightingale’s statement regarding health is “being well and using

every power that the person has to the fullest extent.” In addition she defined disease as” a reparative process that nature instituted from a want of attention.

EnvironmentNightingale’s statements about conditions in the community are also

applicable to her theory. She believed that the sick, poor people would benefit from environmental improvements that she addressed their physical and mental aspect. She stressed that nurses could have a special role in uplifting the social status of the poor by improving their living situations.Reporters:

Arrenz N. Agunday

Javier E. Napili II

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Nursing Science and Theory

in the Early 20th Century

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During the early 20th century , philosophers and scientists argued the use of empiricism and rationalism. The philosophers’ point of view is that knowledge should be based on the understanding of existing theories while scientists believe that knowledge should not only focus on theoretical existence but also on understanding what there is still to be observed.

MAJOR DEVELOPMENTS

- The use of experimentation to gain new knowledge emerged during this period as nurses strive to base their actions on evidence and scientific data.

- POSITIVISM. w/c encloses the use of both logical reasoning and empiricism, became prevalent during this era in the discovery of truth and development of science.

- EMPIRICAL and OBJECTIVE DATA. Co-exist as the focus of interest of study as one of each need to be tested in order to determine as to what is true or what is not.

As a result of the different point of views during this period, the growth of new scientific knowledge commenced. This is evident with

the emergence of radical thinking – rationalism and empiricism.

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RATIONALISM

- It makes use of reason gained thru expert study, tested theory and established facts to evidently prove something. Deductive type of nursing reasoning is used to generate rationalist view which starts from the general to specific knowledge.

This emphasizes the use of reasoning for the main purpose of knowing the harm or benefits of an act to an individual.

EMPIRICISM

-This makes use of objective and tangible data or those that are perceived by the senses to observe and collect data. These data is then used to formulate general knowledge, which is the use of inductive act of reasoning.

- This is highly important in the assessment of patients all throughout the entire nursing process.

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Nursing Science and Theory

in the Late 20th Century

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The development of knowledge in the late 20th century was mainly affected by the different nursing leaders and theorist of the early 20th century. The evolution of nursing science throughout the time was further studied and tested that led to the contemporary practices in nursing . The role of nurses became more defined depending on the different fields of expertise as time progressed.

Erik Erikson Theory Of Personality Development

Lawrence Kohlberg Moral Development Theory

Jean Piaget Cognitive Development

Madeleine Leininger Transcultural Theory

Hildegard Peplau Interpersonal relations in Nursing

Ida Jean Orlando Nursing Process theory

Jean Watson Theory of Human Caring

Myra Estrin Levine Conservation Model

Lydia Hall Core, Care, Cure Theory in Nursing

Faye Abdella Concept of Nursing Diagnosis

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Erik Erikson Theory Of Personality Development

Lawrence Kholberg Moral Development Theory

Jean Piaget Cognitive Development

Madeleine Leininger Transcultural Theory

Hildegard Peplau Interpersonal relations in Nursing

Ida Jean Orlando Nursing Process theory

Jean Watson Theory of Human Caring

Myra Estrin Levine Conservation Model

Lydia Hall Core, Care, Cure Theory in Nursing

Faye Abdella Concept of Nursing Diagnosis

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PROFESSIONAL ROLES OF NURSES

CARE PROVIDER

COMMUNICATOR

TEACHER

COUNSELOR

CLIENT ADVOCATE

CHANGE AGENT

LEADER

MANAGER

RESEARCHER

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EXPANDED ROLES OF NURSES

Nurse Generalist

Nurse Clinician

Nurse Practitioner

Nurse specialist

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Interactive Theories

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Hildegard Peplau“The kind of person

that the nurse becomes makes a substantial difference in what each patient will learn as he or she receives nursing care.”

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Hildegard Peplau– Interpersonal Relations Theory

Born: September 1, 1909Birth Place: Reading, Pennsylvania.Died: March 17, 1999 at Sherman Oaks, California at the age of 89Best Known As: Mother of Psychiatric Nursing and Psychiatric Nurse of the Century.

Hildegard Peplau's Professional Credentialseplau's Professional Credentials• In 1931, Peplau completed a nursing diploma program in her home state. She continued her education and received a Bachelor of Arts in interpersonal psychology from Bennington College. • In 1947, Peplau graduated with a Master of Arts degree in psychiatric nursing from Colombia University.• During World War II, Hildegard Peplau was a member of the Army Nurse Corps and worked in a neuropsychiatric hospital in London, England.• She was the only nurse to serve the ANA as executive director and later as president, she served two terms on the Board of the International Council of Nurses (ICN). In 1997, she received nursing's highest honor, the Christiane Reimann Prize, at the ICN Quadrennial Congress. In 1996, the American Academy of Nursing honored Peplau as a "Living Legend," and, in 1998, the ANA inducted her into its Hall of Fame.

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Hildegard Peplau's Interpersonal Relations in Nursing

Peplau compiled her theoretical framework for psychodynamic nursing into a manuscript entitled Interpersonal Relations in Nursing. Finally published in 1952 after adding a physician as co-author, Peplau's work is considered a middle range descriptive classification theory.

According to Peplau's theoretical framework, the interaction between client and nurse consists of four sequential phases: orientation, identification, exploitation, and resolution. The orientation component of the experience can be influenced by factors associated with both the nurse and patient, such as personal values, culture, beliefs, expectations, and past related incidents.

Roles of Nurses as Described by Hildegard Peplau

Six nursing roles as theorized by Peplau are the stranger, teacher, resource person, counselor, surrogate, and leader.

Secondary roles played by the nurse include the technical expert, mediator, safety agent, researcher, tutor, and manager of environment.

As nurses become self-aware of their own behaviors and patterns, they can connect with patients in a more therapeutic way and foster the concept of nursing as a healing art.

Honored as a "Living Legend" by the American Academy of Nurses, Hildegard Peplau and her Interpersonal Relations Theory leave an undeniable impression and legacy for all levels of nurses and the patients they care for.Reporters:

Fe N. PollosoFebian Jane L.

Paladin

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Virginia Henderson

“The nurse is temporarily the consciousness 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 mouthpiece for those too weak or withdrawn to speak and so on.”

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Virginia Henderson– 14 Basic Human NeedsBorn: November 30, 1897 Birth Place: Kansas City, MissouriDied: March 19, 1996 at Connecticut Hospice at the age of 98Best Known As: First Lady of Nursing and the First Truly International Nurse

Achievements

• She graduated from the Army School of Nursing, Washington, D.C. in 1921. She graduated from Teachers College, Columbia University with a M.A. degree in nursing education.• She has received honorary doctoral degrees from the Catholic University of America, Pace University, University of Rochester,, University of Western Ontario, Yale University• Her stature as a nurse, teacher, author, researcher, and consumer health advocate warranted an obituary in the New York Times, Friday March 22. 1996. In 1985, Miss Henderson was honored at the Annual Meeting of the Nursing and Allied Health Section of the Medical Library Association.• The International Council of Nurses presented her with the first Christiane Reimann Prize in June 1985, aged 87. She was also an honorary fellow of the UK's Royal College of Nursing.

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Contribution

• In 1937 Henderson and others created a basic nursing curriculum for the National League for Nursing in which education was “patient centered and organized around nursing problems rather than medical diagnoses” (Henderson,1991)• In 1939, she revised: Harmer’s classic textbook of nursing for its 4th edition, and later wrote the 5th; edition, incorporating her personal definition of nursing (Henderson,1991)• Although she was retired, she was a frequent visitor to nursing schools well into her nineties. O’Malley (1996) states that Henderson is known as the modern-day mother of nursing.• Her work influenced the nursing profession in America and throughout the world The founding members of ICIRN (Interagency Council on Information Resources for Nursing) and a passionate advocate for the use and sharing of health information resources.• In 1978 the fundamental concept of nursing was revisited by Virginia Henderson from Yale University School of Nursing ( USA ).• She argued that nurses needed to be prepared for their role by receiving the broadest understanding of humanity and the world in which they lived.

Publications

• 1956 (with B. Harmer)-Textbook for the principles and practices of Nursing.• 1966-The Nature of Nursing. A definition and its implication for practice, Research and Education• 1991- The Nature of Nursing Reflections after 20 years• Analysis of Nursing Theory Images of Nursing, 1950-1970

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The 14 components•Breathe normally. Eat and drink adequately.•Eliminate body wastes.•Move and maintain desirable postures.•Sleep and rest.•Select suitable clothes-dress and undress.•Maintain body temperature within normal range by adjusting clothing and modifying

environment•Keep the body clean and well groomed and protect the integument•Avoid dangers in the environment and avoid injuring others.•Communicate with others in expressing emotions, needs, fears, or opinions.•Worship according to one’s faith.•Work in such a way that there is a sense of accomplishment.•Play or participate in various forms of recreation.•Learn, discover, or satisfy the curiosity that leads to normal development and health and

use the available health facilities.

Henderson is famous for a definition 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.“

Virginia Avenel Henderson's national and international achievements made her the quintessential nurse of the twentieth century. Her professional career was launched in Virginia where she served as the first full-time nursing instructor at Norfolk Protestant School of Nursing and took an active role in the state nurses association. A pioneer nurse educator, Henderson was instrumental in pushing for the inclusion of psychiatric nursing in educational programs in Virginia.

Reporters:Kim R. GoyenaLily Grace DV.

Valencia

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Joyce Travelbee

“A nurse does not only 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.”

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Joyce Travelbee (1926–1973) – Human-to-Human Relationship Model

• A psychiatric nurse, educator and writer born in 1926. • 1956, she completed her BSN degree at Louisiana State University• 1959, she completed her Master of Science Degree in Nursing at Yale University • Died at age 47.

Working Experiences

• 1952, Psychiatric Nursing Instructor at Depaul Hospital Affilliate School, New Orleans.• Also she taught at Charity Hospital School of Nursing in Louisiana State University, New York University and University of Mississippi.• 1970, the Project Director of Graduate Education at Louisiana State University School of Nursing until her death.

Publications• 1963, started to publish articles and journals in nursing.• 1966 and 1971, publication of her first book entitled Interpersonal Aspects of Nursing.• 1969, when she published her second book Intervention in Psychiatric Nursing: Process in the One-to-One Relationship.

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Joyce Travelbee’s Human-to-Human Relationship Model

Travelbee's experience in initial psych nursing practice at a Catholic charity hospital led her to believe that the care given in these type of institutions lacked compassion. She felt nursing needed a "humanistic revolution" and a renewed focus on caring as central to nursing--she warned that if this didn't happen, consumers might seek a "new and different kind of health care worker." Travelbee's ideas have greatly influenced the hospice movement. 

She started Doctoral program in Florida in 1973. Unfortunately, she was not able to finish it because she died later that year. She passed away at the prime age of 47 after a brief sickness.

Reporters:Marian P. Aguilas

Ruthleen P. Barnuevo

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Systems Theories

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Betty Neuman

“Health is a condition in which all parts and subparts are in harmony with the whole of the client.”

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Betty Neuman– System Model

• 1924 - Born in Lowell, a village in Washington County, Ohio, United States, along the Muskingum River• 1947 - Obtained her Registered Nurse Diploma from the Peoples Hospital School of Nursing, in Akron Ohio. After that, she went to California where she worked in a hospital as a staff nurse, and eventually became the head nurse. She also explored other fields, and experienced being a school nurse, industrial nurse, and clinical instructor.• 1957 - She went to the University of California at Los Angeles (UCLA) and took a double major in psychology and public health. She received her BS Nursing from this institution.• 1966 - She completed her Masters degree in Mental Health, Public Health Consultation, also at UCLA. She became recognized as a pioneer in the field of nursing involvement in community mental health.• 1970 - Started developing The Systems Model as a way to teach an introductory nursing course to nursing students. The goal was to provide a Holistic overview of the physiological, psychological, sociocultural, and developmental aspects of human beings.• 1972 - After a two-year evaluation of her model, it was eventually published in Nursing Research.• 1985 - She completed her doctorate in Clinical Psychology from Pacific Western University.• 1988 - She founded the Neuman Systems Model Trustee Group, Inc. They are dedicated to the support, promotion and integrity of the Neuman Systems Model to guide nursing education, practice and research.

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•1992 - She was given an Honorary Doctorate of Letters, at the Neumann College, Aston, Pennsylvania.

•1993 - Because of her important contributions to the field on Nursing, Dr. Neuman was named Honorary Member of the Fellowship of the American Academy of Nursing.

•1998 - Received an Honorary Doctorate of Science from the Grand Valley State University in Michigan. For the past years, Dr. Betty Neuman has continuously developed and made famous the Neuman systems model through her work as an educator, author, health consultant, and speaker. Her model has been very widely accepted, and though it was originally designed to be used in nursing and is now being used by other health professions as well.

Betty Neuman’s Systems Model

The main use of the Neuman Model in practice and in research is that its concentric layers allow for a simple classification of how severe a problem is. For example, since the line of normal defense represents dynamic balance, it represents homeostasis, and thus a lack of stress. If a stress response is perceived by the patient or assessed by the nurse, then there has been an invasion of the normal line of defense and a major contraction of the flexible line of defense. Infection or other invasion of the lines of resistance indicates failure of both lines of defense. Thus, the level of insult can be quantified allowing for graduated interventions. Furthermore each person variable can be operationalized and the relationship to the normal line of defense or stress response can be analyzed. The drawback of this is that there is no way to know whether our operationalization of the person variables is a good representation of the underlying theoretical structures.

Reporters:Abegail R. Balmaceda

Hianalou N. Benito

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Dorothy E. Johnson

“Each individual has a redisposition to act, with reference to the goal, in certain ways rather than in other ways.”

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Dorothy E. Johnson– Behavioral System ModelBorn: August 21, 1919Birth Place: Savannah, GeorgiaDied: February 1999 at the age of 80

• 1938 - She received her A. A. from Armstrong Junior College in Savannah, Georgia. 1942 - Her B. S. N. from Vanderbilt University in Nashville, Tennessee. • 1948 - Her M.P.H. from Harvard University in Boston in. • Johnson was an instructor and an assistant professor in pediatric nursing at Vanderbilt University School of Nursing from 1944 to 1949. • From 1949 until her retirement in 1978 and subsequent move to Key Largo, Florida, she was an assistant professor of pediatric nursing, an associate professor of nursing, and a professor of nursing at the University of California in Los Angeles.• In 1955 and 1956 she was eligible to go on a sabbatical and went to the Christian Medical College School of Nursing in Vellore, South India, were she was interested in starting a baccalaureate program which was received well (Lobo, 1995). Dorothy Johnson has had an influence on nursing through her publications since the 1950s. Throughout her career, Johnson has stressed the importance of research-based knowledge about the effect of nursing care on clients.

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Johnson was an early proponent of nursing as a science as well as an art. She also believed nursing had a body of knowledge reflecting both the science and the art. From the beginning, Johnson (1959) proposed that the knowledge of the science of nursing necessary for effective nursing care included a synthesis of key concepts drawn from basic and applied sciences. In 1961, Johnson proposed that nursing care facilitated the client's maintenance of a state of equilibrium. Johnson proposed that clients were "stressed" by a stimulus of either an internal or external nature. These stressful stimuli created such disturbances, or "tensions," in the patient that a state of disequilibrium occurred. Johnson identified two areas that nursing care should be based in order to return the client to a state of equilibrium. First, by reducing stressful stimuli, and second, by supporting natural and adaptive processes. Johnson's behavioral system theory springs from Nightingales belief that nursing's goal is to help individuals prevent or recover from disease or injury. The "science and art" of nursing should focus on the patient as an individual and not on the specific disease entity. Johnson used the work of behavioral scientists in psychology, sociology, and ethnology to develop her theory. The model is patterned after a systems model; a system is defined as consisting of interrelated parts functioning together to form a whole.

 Johnson's theory could help guide the future of nursing theories, models, research, and education. By focusing on behavioral rather than biology, the theory clearly differentiates nursing from medicine. But do we need to separate the behavioral from the biological. It can be an asset, and it can work, that has been proven by Johnson and some of her followers. In order to focus on the holistic idea of nursing, it is important to think of the behavioral and biological together as health. We cannot look at one without looking at the other. There is not sufficient research to substantiate the real applicability of this model. This theory does provide a conceptual framework to work from, but this model will never be the standard for nursing.

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Imogene King“If the students can’t

do the Fundamentals, How can they use advanced knowledge?”

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Imogene King– Goal Attainment TheoryBorn: January 30, 1923 Birth Place: West Point, IowaDied: December 24, 2007 at South Pasadena at the age of 84

CREDENTIALS AND BACKGROUND

• 1945 - Imogene King earned a Diploma in Nursing from St. John’s Hospital School of Nursing St. Louis, Missouri.• 1948 - BS in Nursing Education, St. Louis University.• 1957 - Earned M.S.N, from St. Louis University.• 1961 - Doctor of Education, from Teachers College, Columbia University.• 1980 - Awarded an honorary PhD. Southern Illinois University.• Dr. King began her academic career at St. Louis University. From 1947 to 1958, she worked as an instructor in MSN and as an assistant director at St. John’s Hospital of Nursing• From 1961 to 1966 she was an Associate Professor of Nursing at Loyola University in Chicago where she developed Master’s Degree program in Nursing based on a nursing conceptual framework.• From 1968 to 1972 she was the director of the School of Nursing at Ohio University in Columbus. • In 1972, King returned to Chicago as a professor in Loyola Univ. graduate programs.• From 1972 to 1975, she was a member of the Defense Advisory and Committee on Women in the Services for the United States Department of Defense.• Served as the coordinator of Research in Clinical Nursing at the Loyola Medical Center, Department of Nursing, from -1978 to 1980.• King moved to Tampa Florida, where she was appointed professor of the University of South Florida College of Nursing.-1980• She retired in the year 1990 and is currently professor emeritus at the University of South Florida.• King has been an active member of the American Nurses Association, the Florida Nurses Association and Sigma Theta Tau International.• King is one of the founding members of a nursing organization, the King International Nursing Group.

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King’s Works

The conceptual framework that King developed involves three interacting sets of systems. On the smallest level are personal systems, comprised of individuals. Examples of personal systems are individual nurses and patients. The second level of systems is the interpersonal systems, or groups. These are generally small groups. A family is an interpersonal system, and when a nurse and patient interact they also form an interpersonal system. The largest systems are social systems, or societies. Examples of social systems are religious organizations, universities, and hospitals.

The theory of goal attainment, which lies at the heart of King's theory of nursing, exists in the context of her conceptual framework. The essence of goal attainment theory is that the nurse and the patient work together to define and reach goals that they set together. The patient and nurse each perceive, judge, and act, and together the patient and nurse react to each other and interact with each other. At the end of this process of communication and perceiving, if a goal has been set a transaction is said to have occurred. The nurse and patient also decide on a way to work toward the goal that has been decided upon, and put into action the plan that has been agreed upon. King believes that the main function of nursing is to increase or to restore the health of the patient, so then, transactions should occur to set goals related to the health of the patient. After transactions have occurred and goals have been defined by the nurse and patient together, both parties work toward the stated goals. This may involve interactions with other systems, such as other healthcare workers, the patient's family, or larger systems.

After the transaction has occurred, and the goal has been set, King believes that it is important for good documentation to be practiced by the nurse. She believes that documenting the goal can help to streamline the process of goal attainment, making it easier for nurses to communicate with each other and other healthcare workers involved in the process. It also helps to provide a way to determine if the goal is achieved. This assessment of whether or not the goal has been successfully achieved plays an important end stage in King's goal attainment theory.

Reporters:Jeralyn V. Berma

Baby Jean S. Regalario

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Dorothea E. Orem

“Individuals, families, groups and communities need to be taught self care.”

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Dorothea E. Orem– Self-Care Deficit TheoryBorn: 1914Birth Place: Baltimore, MarylandDied: June 22, 2007

Education• Studied at Providence Hospital School of Nursing in Washington, D.C. in 1930’s• Got her B.S.N.E. in 1939 and her M.S.N.E. in 1946 both from the Catholic University of America.• 1958-1960 upgraded practical nursing training at Department of Health Education and Welfare.• Was editor to several texts including Concepts Formalization in Nursing: Process and Production, revised in 1980, 1985, 1991, 1995, 2001.

Achievements• 1976 and 1980 Honorary degree of Doctor of Science• 1980 CUA Alumni Association Award for Nursing Theory• 1988 Doctor of Humane Letters for Illinois Wesleyan University• 1991 National League for Nursing• 1992 Honorary Fellow of the American Academy of Nursing• 1998 Doctor for Nursing Honoris Causae from the University of Missouri.

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Development of Theory

• 1949-1957 Orem worked for the Division of Hospital and Institutional Services of the Indiana State Board of Health. Her goal was to upgrade the quality of nursing in general hospitals throughout the state. During this time she developed her definition of nursing practice. • 1958-1960 U.S Department of Health, Education and Welfare where she help publish “Guidelines for Developing Curricula for the Education of Practical Nurses” in 1959. • 1959 Orem subsequently served as acting dean of the school of Nursing and as an assistant professor of nursing education at CUA. She continued to develop her concept of nursing and self care during this time. • Orem’s Nursing: Concept of Practice was first published in 1971 and subsequently in 1980,1985, 1991, 1995, and 2001. • Continues to develop her theory after her retirement in 1984 Theory of Self CareThis theory Includes:• Self care – practice of activities that individual initiates and perform on their own behalf in maintaining life ,health and well being• Self care agency – is a human ability which is "the ability for engaging in self care" -conditioned by age developmental state, life experience sociocultural orientation health and available resources• Therapeutic self care demand – "totality of self care actions to be performed for some duration in order to meet self care requisites by using valid methods and related sets of operations and actions"• Self care requisites-action directed towards provision of self care. 3 categories of self care requisites are:

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1.  Universal•Developmental•Health deviation2. Universal self care requisites•Associated with life processes and the maintenance of the integrity of human structure and functioning•Common to all , ADL•Identifies these requisites as:•Maintenance of sufficient intake of air ,water, food•Provision of care assoc with elimination process•Balance between activity and rest, between solitude and social interaction•Prevention of hazards to human life well being and•Promotion of human functioning3. Developmental self care requisites•Associated with developmental processes/ derived from a condition…. Or associated with an event

E.g. adjusting to a new jobadjusting to body changes

•Health deviation self careRequired in conditions of illness, injury, or disease .these include:--Seeking and securing appropriate medical assistanceBeing aware of and attending to the effects and results of pathologic conditionsEffectively carrying out medically prescribed measuresModifying self concepts in accepting oneself as being in a particular state of health and in specific forms of health careLearning to live with effects of pathologic conditions.

Reporters:Sheila Mae R.

RamirezJuvy P. San Juan

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Faye Glenn Abdellah

“I never wanted to be a medical doctor because I could do all I wanted to do in nursing, which is a caring profession.”

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Faye Glenn Abdellah– 21 Nursing ProblemsBorn: March 13, 1919Birth Place: New York CityBest Known As: International Expert on Health Problems

• Faye Glenn Abdellah was one of the most influential nursing theorist and public health scientist in our era. It is extremely rare to find someone who has dedicated all her life to the advancement of the nursing profession and accomplish this feat with so much distinction and merit. In fact, when she was inducted into the National Women's Hall of Fame in 2000, Abdellah said, "We cannot wait for the world to change.… Those of us with intelligence, purpose, and vision must take the lead and change the world. Let us move forward together! … I promise never to rest until my work has been completed!“

• Faye Glenn Abdellah was born on March 13, 1919, in New York City. Years later, on May 6, 1937, the German hydrogen-fueled airship Hindenburg exploded over Lakehurst, New Jersey, where 18-year-old Abdellah and her family then lived, and Abdellah and her brother ran to the scene to help. In an interview with a writer for Advance for Nurses, Abdellah recalled: "I could see people jumping from the zeppelin and I didn't know how to take care of them, so it was then that I vowed that I would learn nursing."

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Educational achievements

In 1942, Abdellah earned a nursing diploma and is magna cum laude from Fitkin Memorial Hospital's School of Nursing New Jersey (now Ann May School of Nursing). 

She received her Bachelor of Science Degree in 1945, a Master of Arts degree in 1947 and Doctor of Education in Teacher’s College, Columbia University. In 1947 she also took Master of Arts Degree in Physiology. With her advanced education, Abdellah could have chosen to become a doctor. However, as she explained in her Advance for Nurses interview, "I never wanted to be an M.D. because I could do all I wanted to do in nursing, which is a caring profession.”

Established Nursing Standards

In another innovation within her field, Abdellah developed the Patient Assessment of Care Evaluation (PACE), a system of standards used to measure the relative quality of individual health-care facilities that was still used in the health care industry into the 21st century. She was also one of the first people in the health care industry to develop a classification system for patient care and patient-oriented records. 

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ABDELLAH'S TYPOLOGY OF 21 NURSING PROBLEMS

1. To maintain good hygiene and physical comfort.2. To promote optimal activity: exercise, rest, and sleep.3. To promote safety through prevention of accident, injury, or other trauma and through the prevention of the spread of infection.4. To maintain good body mechanics and prevent and correct deformity.5. To facilitate the maintenance of a supply of oxygen to all body cells.6. To facilitate the maintenance of nutrition of all body cells.7. To facilitate the maintenance of elimination.8. To facilitate the maintenance of fluid and electrolyte balance.9. To recognize the physiological responses of the body to disease conditions—pathological, physiological, 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.13. To identify and accept 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 of personal spiritual goals17. To create and/or maintain a therapeutic environment.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 arising from illness.21. To understand the role of social problems as influencing factors in the cause of illness.

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Dr. Abdellah's work has been recognized with 77 professional and academic honors, including the prestigious Allied Signal Award for her pioneering research in aging. She is also the recipient of eleven honorary degrees.

Faye Glenn Abdellah (born 1919) dedicated her life to nursing and, as a researcher and educator, helped change the profession's focus from a disease-centered approach to a patient-centered approach. She served as a public health nurse for 40 years, helping to educate Americans about the needs of the elderly and the dangers posed by AIDS, addiction, smoking, and violence. As a nursing professor, she developed teaching methods based on scientific research. Abdellah continued to work as a leader in the nursing profession into her eighties.

Reporters:Kimberly P. GilPrincess Jean P.

Chavez

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DevelopmentalTheories

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Sister Callista Roy

“The model provides a way of thinking about people and their environment that is useful in any setting. It helps one prioritize care and challenges the nurse to move the patient from survival to transformation.”

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Sister Callista Roy– Adaptation ModelBorn: Oct.14 1939Birth Place: Los Angeles, California

• She received a Bachelor’s degree in Nursing in 1963 from Mont Saint Mary’s College in Los Angeles and a Master’s degree in Nursing from the University of California, Los Angeles in 1963.• Roy begun her education in Sociology receiving both a master’s degree in Sociology in 1973 and a Doctorate in Sociology in 1977 from the University of California.• In 1987, Roy began the newly created position of Nurse Theorist at Boston College School of Nursing. • Roy is a member Sigma Theta Tau and she received the National Founders Award for excellence in Fostering Professional Nursing Standard in 1981. • Her achievements include an Honorary Doctorate of Humane Letters by Alverno College,(1984) Honorary Doctorates from Eastern Michigan University(1985) and Saint Joseph’s College in Maine(1999), and an American Journal of Nursing Book of the Year Award for Essentials of Roy Adaptation Model. • Roy has begun recognized in the world who’s who of women(1979), personalities of America(1978), as a fellow of America Academy of Nursing(1978), Recipient of a Fulbright senior Scholar Award from the Australian-American Educational Martha Roger’s Award for advancing Nursing Science from the National League for Nurse’s(1991).• Roy received the outstanding Alumna Award and the prestigious Carondelet medal from her Alma mater, Mount Saint Mary’s.

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Roy Adaptation Model

Roy, a sister of saint Joseph of Carondelet, developed the Roy adaptation model (RAM)in response to a challenge by her professor, Dorothy E. Johnson. Since then, the RAM has been conceptualized to be used in the 21st Century. The expansion of the model has been a vibrant process.

Roy recognized the work of Von Bertalanffy’s (1964) Adaption theory as a basis of scientific assumption for her model.

The Roy adaptation model contains the following key concept:

• The person is adapting in a stable interaction with the environment either internal or external.

• The environment serves as the source of a range of stimuli that will either internal or external.

• The person’s major task is to maintain integrity in face of these environmental stimuli.

Roy and Andrews (1999) defined integrity as the degree of wholeness

Achieved by adapting to changes in needs. Reporters:

Paula M . PauloJacinth A. Atacador

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Madeleine Leiniger

“Care is the heart of nursing; Care is power; Care is essential to healing; Care is curing; and Care is the central and dominant focus of nursing and transcultural nursing decisions and actions.”

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Madeleine Leininger– Transcultural TheoryBorn: July 13, 1925

• She obtained her basic nursing education at St. Anthony School of Nursing, Denver, Colorado, and graduated in 1948. She merited her Bachelor of Science degree from Benedectine College. Atchison, Kansas .In 1953, she obtained her degree of Master of Science Seattle. A Fellow in the American Academy of Nursing , She was conferred an LHD ( Doctor of Humane Letters, honorably given) from Benedectine College• She became aware of the importance of caring to nursing in the year 1940. Statements made by patients expressing their appreciation for nursing care changed her view of caring values and led her focus on care as dominant culture of nursing . In the mid-1950’s, she went through what she relates to as a culture shock while she was a nurse in a child guidance home in the Midwestern United States.• This experience led her to become the first professionals nurse in the world to earn a doctorate in anthropology, and led to the development of the new field of Transcultural Nursing as a subfield of nursing. In 1966’s , she offered the first transcultural nursing course with field experiences and has been instrumental in the development of similar courses at a number of other institutions. She development her theory of Transcultural Nursing. With this emerging recognition of care as the main component to nursing knowledge and practice she labeled her theory culture care. She drew upon anthropology for the culture component and upon for the care component.

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Transcultural Theory in NursingLeininger first showed her presentation of the theory in 1985 She

presented her assumptions which support her claim that “Different cultures perceive, know and practice in different ways yet there is some communality about care among all cultures of the world. Culture is the learned, shared, and transmitted values, beliefs, norms, and life ways of a particular group that guides their thinking , decisions and actions in patterned ways. A key component of Leininger’s theory is that of cultural diversity. This refers to the differences of variations that can be found both between and among different cultures.. A similar component is that of cultural universality, the opposite of diversity. These ideas had led to an important achievement of the theory- that is to discover similarities and differences about care and its impact and the health and well being of groups.

Culturalogical assessment for comprehensive, holistic overview of client's background:•communication and language•gender considerations•sexual orientation•ability/disability•occupation•age•socioeconomic status•interpersonal relationships•appearance•dress•use of space•foods•meal preparation and related life ways

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Leininger's theoretical assumptions and orientational definitions:

1. Care is the essence of nursing and a distinct, dominant, and unifying focus.2. Care (caring) is essential for well being, health, healing, growth survival, and to face handicaps or death.3. Culture care is the broadest holistic means to know, explain, interpret, and predict nursing care phenomena to guide nursing care practices.4. Nursing is a transcultural, humanistic and scientific care discipline and profession with the central purpose to serve human beings worldwide.5. Care (caring) is essential to curing and healing, for there can be no curing without caring.6. Culture care concepts, meanings, expressions, patterns, processes, and structural forms of care are different (diversity) and similar (towards commonalities or universalities) among all cultures of the world.7. Every human culture has lay (generic, folk, or indigenous) care knowledge and practices and usually some professional care knowledge and practices which vary transculturally.

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8. Cultural care values, beliefs, and practices are influenced by and tend to be embedded in worldview, language, religious (or spiritual), kinship (social), political (or legal), educational, economic, technological, ethnohistorical, and environmental context of a particular culture.9. Beneficial, healthy, and satisfying culturally based nursing care contributes to the well being of individuals, families, groups, and communities within their environmental context.10. Culturally congruent or beneficial nursing care can only occur when the individual, group, community, or culture care values, expressions, or patterns are known and used appropriately and in meaningful ways by the nurse with the people.11. Culture care differences and similarities between professional caregiver(s) and client (generic) care-receiver(s) exist in any human culture worldwide.12. Clients who experience nursing care that fails to be reasonably congruent with their beliefs, values, and caring life ways will show signs of cultural conflicts, noncompliance, stresses and ethical or moral concerns.13. The qualitative paradigm provides new ways of knowing and different ways to discover the epistemic and ontological dimensions of human care transculturally.

Reporters:Rhea B. BodinoEnna Marie V.

Sabatin

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Margaret Jean Watson

“Caring in nursing conveys physical acts, but embraces the mind-body-spirit as it reclaims the embodied spirit as its focus of attention.”

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Margaret Jean Watson– Philosophy and Science of Caring

•She was born in Southern West Virginia and grew up during the 1940’s and 1950’s in the small town of Welch, West Virginia in the Appalachian Mountains.•As the youngest of eight children, she was surrounded by an extended family-community environment.•After graduation in 1961, she married her husband, Douglas, and moved west to his native state of Colorado. Douglas whom Watson describes not only as her physical and spiritual partner, but also as her best friend, died in 1998.•She has two grown daughters, Jennifer (born in 1963) and Julie (born in 1967), and five grandchildren.

EDUCATIONAL BACKGROUND

She attended high school in West Virginia and then the Lewis Gale School of Nursing in Roanoke, Virginia.After moving to Colorado, Watson continued her nursing education and graduate studies at the University of Colorado.She earned a baccalaureate degree in psychiatric-mental health nursing in 1966 at the Health Sciences campus, and a doctorate in educational psychology and counseling in 1973 at the Graduate School, Boulder campus.

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PROFESSIONAL BACKGROUNDAfter her doctoral degree, she joined the School of Nursing faculty of the University of Colorado Health Sciences Center in Denver, where she has served as chairperson and assistant dean of the undergraduate program, and she was involved in early planning and implementation of the nursing Ph.D. program in Colorado, which was initiated in 1978.She was coordinator and director of the Ph.D. program between 1978 and 1981.In 1981 and 1982, she pursued international sabbatical studies and diverse learning experiences in New Zealand, Australia, India, Thailand, and Taiwan.Upon her return, she was appointed dean of the University of Colorado School of Nursing and Associate Director, Nursing Practice at University Hospital from 1983-1990.She is currently a Distinguished Professor of Nursing and holds the Murchinson-Scoville Endowed Chair in Caring Science at the University of Colorado School of Nursing.She continues to offer her basic theory courses as part of the International Certificate Program in Caring-Healing, which can be taken for credit twice a year.During her deanship, she was instrumental in the development of a post baccalaureate nursing curriculum in human caring, health, and healing, which leads to a career professional clinical doctoral degree (ND).This pilot ND program was selected as a national demonstration program by the Helene Fuld Health Trust in New York and was funded by the Trust and Colorado clinical health care agencies.

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The Center for Human Caring was established in the 1980s by Watson and colleagues at the University of Colorado; it was the nation’s first interdisciplinary center with an overall commitment to develop and use knowledge of human caring and healing as the moral and scientific basis of clinical practice and nursing scholarship and as the foundation for efforts to transform the current health care system (Watson, 1986).Watson has been active in community programs, having served as an earlier founder and member of the Board of Boulder Country Hospice, and she has initiated numerous collaborations with area health care facilities.Other honors include honorary doctoral degrees from at least 6 universities in the United States and abroad including Assumption College in Worcester, Massachusetts, the University of Akron, Ohio, the University of Montreal in Quebec, Canada.She also received the high honor of Distinguished Professor of Nursing at the University of Colorado in 1992.In 1993, she was recipient of the National League for Nursing (NLN) Martha E. Rogers Award, which recognizes a nurse scholar who has made significant contributions to nursing knowledge that advance the science of caring in nursing and health sciences.Between 1993 and 1996, Watson served as a member of the Executive Committee, the Governing Board, and as an officer for the NLN.She was president from 1995-1996.In 1997, she was given an honorary lifetime certification as a holistic nurse.In 1998. she was recognized as a Distinguished Nurse Scholar by New York University.And in 1999, she was honored with the national Norman Cousins Award by the Fetzer Institute in recognition of her commitment to developing, maintaining and exemplifying relationship-centered care practices (Watson, personal communication, August 14, 2000).

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WORKSHer international works include an International Kellogg Fellowship in Australia (1982), a Fulbright Research and Lecture Award to Sweden and other parts of Scandinavia (1991), and a lecture tour in the United Kingdom (1993).Watson is featured in several nationally distributed videotapes on nursing theory. These include “Circles of Knowledge” and “Conversations on Caring with Jean Watson and Janet Quinn” from the NLN, “Portraits of Excellence: Nursing Theorists and Their Work” from the Helene Fuld Health Trust, and “Theory in Practice” from the NLN.Nursing: The Philosophy and Science of CaringNursing: Human Science and Human Care-A Theory of Nursing, published in 1985 and reprinted in 1988 and 1999.Postmodern Nursing and Beyond, published in 1999. Most recent work.

Watson herself noted that the ideas associated with her philosophy and theory of human caring are concerned with spirit than matter, flux rather than form, inner knowledge and power rather than circumstance. These thoughts are never final, but they are embedded with persistent values and moral imperatives related to human interaction that flows between and connects the one-caring-for and the one-cared-for. She has moved beyond contemporary nursing to a view that is rooted in Nightingale’s vision. She reflects, “it is both theoretical and beyond theory”.

Reporters:Ezra G. CortezDonna Marie T.

Papa

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Patricia Benner

“Nursing is concerned with the social sentient body that dwells infinite human worlds; they get sick and recovers; that is altered during illness, pain and suffering; and that engages with the world differently upon recovery.”

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Patricia Benner– From Novice to Expert

•Patricia Benner was born in Hampton, Virginia, and spent her childhood in California, where she had her early and professional education.•She received her Bachelor’s Degree in Nursing from Pasadena College in 1964, her Master’s Degree in Medical Surgical Nursing from the University of California, San Francisco, in 1970 and her PhD from the University of California, Berkely.•Upon completion of her doctorate in 1982, Benner achieved the position of Associate Professor in 1989 in the Department of Physiological Nursing in the School of Nursing at the University of California, San Francisco and became tenured professor in 1989. In 2002, she moved to the Department of Social and Behavioral Sciences at UCSF, where she is a professor and the first occupant of the Thelma Shobe Cook Endowed Chair in Ethics and Spirituality.•WORKS•Dr. Benner acknowledged that her thinking in Nursing had been influenced greatly by Virginia Henderson, who commented that because of the nature and scope of her work, “From Novice to Expert,” it had the potential to materially affect practice and at the same time, the nurses’ preparation.•Dr Patricia Benner introduced the concept that expert nurses develop skills and understanding of patient care over time through a sound educational base as well as a multitude of experiences.•She proposed that one could gain knowledge and skills ("knowing how") without ever learning the theory ("knowing that").•She further explains that the development of knowledge in applied disciplines such as medicine and nursing is composed of the extension of practical knowledge (know how) through research and the characterization and understanding of the "know how" of clinical experience.•She conceptualizes in her writing about nursing skills as experience is a prerequisite for becoming an expert.

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From Novice to Expert

Presents a model of nursing practice describing five levels of competency. Each level is described in the words of nurses who were interviewed and observed individually and in small groups, in patient care situations where the nurse made a positive difference in patient outcome. Asserts that perceptual awareness is central to good nursing judgement and that this begins with intuition followed by critical analysis. Discussion encompasses the helping role, the phenomenon of caring, management of rapidly changing situations, and collaborative relationships.

Levels of Nursing experienceShe described 5 levels of nursing experience as;

NoviceAdvanced beginnerCompetentProficientExpert

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These levels reflect:

movement from reliance on past abstract principles to the use of past concrete experience as paradigms andchange in perception of situation as a complete whole in which certain parts are relevant

•Each step builds on the previous one as abstract principles are refined and expanded by experience and the learner gains clinical expertise.•This theory changed the profession's understanding of what it means to be an expert, placing this designation not on the nurse with the most highly paid or most prestigious position, but on the nurse who provided "the most exquisite nursing care.•It recognized that nursing was poorly served by the paradigm that called for all of nursing theory to be developed by researchers and scholars, but rather introduced the revolutionary notion that the practice itself could and should inform theory.

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Local Conceptual Models

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Sister Carolina S. Agravante

Reporters:Sherline P.

CasasisSunshine L.

Sergio

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CREDENTIALS AND BACKGROUND

Sister Carolina S. Agravante is the University President of St. Paul University- Iloilo

In the year 1964 she graduated BS Nursing, Magna Cum Laude in St. Paul College – Manila.

She was the 1st Placer in the Nurse’s Licensure Examination that year. She took her MS in Nursing Education as a University Scholar at the Catholic University of America in 1970.

She completed her PhD in Nursing at UP Manila in 2002.

In June 21, 2004 she was installed as the 1st President of St. Paul University – Iloilo, held in Marian Hall.

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Carmelita Divinagracia

Reporters:Jenica B.

MirabuenoLhynn N. Rejalde

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• Dr. Carmelita A. Divinagracia is a Master of Nursing in 1975.

• She received her doctoral degree holder in 2001, has been lauded for developing the art and competency of teaching nursing.

• She has lectured and written about her work as a nurse and how she has used her hands-on experience to develop better ways to teach nursing.• Her love for nursing and her dedication to carve out learning tools for nursing students, has been a commendable and rare field of discipline.

• As a teacher, she could not be anything else but a perfect thesis adviser.

• She has teamed up with the Commission on Higher Education for the drafting of a higher standard of competency in nursing schools in the Philippines.

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The Professional Regulation Commission awarded the Outstanding Professional Nurse for 2009 upon Dr. Carmelita C. Divinagracia, the incumbent Dean of the UERMMMCI College of Nursing. This recognition is the highest award for a professional nurse in the country. The ceremony was held last June 19 at the Fiesta Pavilion of the historic Manila Hotel.

Dean Divinagracia’s numerous and substantial contributions to the nursing profession, both locally and abroad, brought about remarkable transformation in the nursing profession. It includes the critical role she played in the 2006 Integrated Nurses Licensure Examination (INLE), her dynamic governance of the Association of Deans of Philippines Colleges of Nursing (ADPCN) being its National President, the vital role she played as a conduit of change in issues concerning nursing in government and international concerns and her key role in sustaining the premier status of the UERMMMCI College of Nursing as one of the top performing nursing schools in the country. More so, through her leadership the College is now recognized by the Commission on Higher Education (CHED) as a Center of Excellence for Nursing Education.

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Carmencita M. Abaquin

Reporter:James Joel Delos

ReyesMarc Gil M. San

Esteban

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Biographic Sketch

Carmensita M. Abaquin is a nurse with Master’s Degree in Nursing obtained from the University of the Philippines College of Nursing. An expert in Medical Surgical Nursing with subspecialty in Oncologic Nursing, which made her known both here and abroad. She had served the University of the Philippines College of Nursing, as faculty and held the position as Secretary of the College of Nursing. Her latest appointment as Chairman of the Board of Nursing speaks of her competence and integrity in the field she has chosen.

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Desertion“PREPARE ME” Interventions and the quality

of Life of Advance Progressive Cancer Patients

Holistic Nursing Intervention

“PREPARE ME”

* Presence

• Remittance therapy

• Prayer

• Relaxation Activities

• Meditation

• Value Clarification

Terminally III Patients(Cancer)PhysicalSocial

ReligiousLevel of Independence

EnvironmentSpiritual

SYMPTON RELIEF QUALITY

OF LIFE

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About her Theory:

“PREPARE ME” Interventions and the Quality of Life Advance Progressive Cancer Patients.

Basic Assumptions and Concepts:

PREPARE ME (Holistic Nursing Interventions) are the nursing interventions provided to address the multi-dimensional problems of cancer patients that can be given in any setting where patients choose to be confined. This program emphasizes a holistic approach to nursing care. PREPARE ME has the following components:

Presence – being with another person during the times of need. This includes therapeutic communication, active listening, and touch.

Reminisce Therapy – recall of past experiences, feelings and thoughts to facilitate adaptation to present circumstances.

Prayer Relaxation-Breathing – techniques to encourage and elicit relaxation for the

purpose of decreasing undesirable signs and symptoms such as pain, muscle tension, and anxiety.

Meditation – encourages an elicit form of relaxation for the purpose of altering patient’s level of awareness by focusing on an image or thought to facilitate inner sight which helps establish connection and relationship with God. It may be done through the use of music and other relaxation techniques.

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Values Clarification – assisting another individual to clarify his own values about health and illness in order to facilitate effective decision making skills. Through this, the patient develops an open mind that will facilitate acceptance of disease state or may help deepen or enhance values. The process of values clarification helps one become internally consistent by achieving closer between what we do and what we feel.

Quality of Life

A manufactured construct that encompasses the individual’s capacities and abilities with an aim of enriching life when it can no longer be prolonged. This includes proper care of the body, mind, and spirit to maintain integrity of the whole person despite limitations brought by the present situation. This can be seen with the following dimensions of man – physical, psychological, social, religious, level of independence, environment, and spiritual.

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Findings and Recommendations

1. Terminally-ill patients require holistic approach of nursing that encompasses the different aspects of man namely physical, psychological, social, religious, level of independence, environment, and spiritual. In this premise, patients with incurable illness, specifically cancer patients, require a whole faceted care that will improve the quality of their life.

2. PREPARE ME Interventions are said to be effective in improving the quality of life of cancer patients. This can be further applied not only with terminally-ill patients but also promisingly introduced to those patients with acute and chronic diseases and those with prolonged hospital stays.

3. The utilization of the intervention as a basic part of care given to cancer patients is recommended, as well as the incorporation of the patients. The said components of PREPARE ME must be introduced and focused during the training of nurses both in the academe and practice to answer the needs of this special kind of clients.

4. Development of training programs for care providers, as well as health care professionals where intervention is a part of treatment modalities, is also recommended.

5. For patients, an honest view and feedback regarding their illness and management, and obtaining their perceptions can lead to improvement of services and communication between patients with advanced progressive cancer, their families and health team.

6. Supportive environment where patients with advanced progressive cancer and the terminally-ill patients can attain dignity of dying with peace while their families are given the necessary support they need to cope up with. Thus, healthcare professionals and family members have to provide this kind of venue whether in the home of hospital setting. This will maintain a holistic support for this special type of clients.

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Letty Kuan

Reporters:Dana Mae A.

BubanYsalou D.

Recato

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• Sister Letty G. Kuan is a nurse with Master’s Degree in Nursing and Guidance Counseling.• She also holds a Doctoral Degree in Education. For her vast contributions to the University of the Philippines College of Nursing faculty and academic achievements, she is now Professor Emeritus, a title awarded only to a few who met the strict criteria.• She had two Master’s Degrees, MA in Nursing and MS Education, Major in Guidance Counseling, culminating in Doctor of Education (Guidance and Counseling).• She has clinical fellowship and specialization in Neuropsychology in University of Paris, France (Salpetriere Hospital). Neurogerontology in Waterson, New York (Good Samaritan Hospital) and Syracuse University, New York. She also had Bioethics formal training at Institute of Religion, Ethics and Law at Baylor College of Medicine in Houston, Texas.• She authored several books giving her insight in the areas of Gerontology, Care of Older Persons and Bioethics.• She is a recipient of the Metrobank Foundation Outstanding Teachers Award in 1995 and an Award for Continuing Integrity and Excellence in Service (ACIES) in 2004. Her religious community is the Notre Dame de Vie founded in France in 1932.• As a former member of the Board of Nursing, her legacy to the Nursing Community is without a doubt, indisputable.

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About her Theory:“Retirement and Role Discontinuities”

Basic Assumptions and Concepts:

• Physiological Age is the endurance of cells and tissues to withstand the wear-and-tear phenomenon of the human body. Some individuals are gifted with strong genetic affinity to stay young for a long time.• Role refers to the set of shared expectations focused upon a particular position. These may include beliefs about what goals or values the position incumbent is to pursue and the norms that will govern his behavior. It is also the set of shared expectations from the retiree’s socialization experiences and the values internalized while preparing for the position as well as the adaptations to the expectations socially defined for the position itself. For every social role, there is complementary set of roles in the social structure among which interaction constantly occurs.• Change of Life is the period between near retirement and post retirement years. In medico-physiologic terms, this equates with the climacteric period of adjustment and readjustment to another tempo of life.• Retiree is an individual who has left the position occupied for the past years of productive life because he/she has reached the prescribed retirement age of has completed the required years of service.

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• Role Discontinuity is the interruption in the line of status enjoyed or role performed. The interruption may be brought about by an accident, emergency, and change of position or retirement.• Coping Approaches refer to the interventions or measures applied to solve a problematic situation or state in order to restore or maintain equilibrium and normal functioning.

Determinants of positive perceptions in retirement and positive reactions toward role discontinuities:

1. Health Status – refer to physiological and mental state of the respondents, classified as either sickly or healthy.2. Income – (economic level) refers to the financial affluence of the respondent which can be classified as poor, moderate or rich.3. Work Status4. Family Constellation – means the type of family composition described either close knit or extended family where three more generations of family members live under one roof; or distanced family, whose member live in separate dwelling units; or nuclear type of family where only husband, wife and children live together.5. Self-Preparation

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PROBLEM TREE AND

FISH BONE

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STEPS IN PROBLEM TREE

1. List all the problems that come to mind. Problems need to be cully identified: they should be existing problems, not possible, imagined or future ones. The problem is an existing negative situation, it is not the absence of a solution.

2. Identify a core problem (this may involve considerable trial and error before settling on one).

3. Determine which problems are “Causes” and which are “Effects.”

The Problem Tree Method is a planning method based on needs, however it is not a mechanical translation of problems into objectives.

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4. Arrange in hierarchy both Causes and Effects, i.e., how do the causes relate to each other - which leads to the other, etc.

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Problem tree analysis is central to many forms of project planning and is well developed among development agencies. Problem tree analysis (also called Situational analysis or just Problem analysis) helps to find solutions by mapping out the anatomy of cause and effect around an issue in a similar way to a Mind map, but with more structure. This brings several advantages:

Problem tree analysis is central to many forms of project planning and is well developed among development agencies. Problem tree analysis (also called Situational analysis or just Problem analysis) helps to find solutions by mapping out the anatomy of cause and effect around an issue in a similar way to a Mind map, but with more structure. This brings several advantages:

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Fishbone DiagramA Problem-Analysis Tool

What is a Fishbone diagram?

Dr. Kaoru Ishikawa, a Japanese quality control statistician, invented the fishbone diagram. Therefore, it may be referred to as the Ishikawa diagram. The fishbone diagram is an analysis tool that provides a systematic way of looking at effects and the causes that create or contribute to those effects. Because of the function of the fishbone diagram, it may be referred to as a cause-and-effect diagram. The design of the diagram looks much like the skeleton of a fish. Therefore, it is often referred to as the fishbone diagram.

Whatever name you choose, remember that the value of the fishbone diagram is to assist teams in categorizing the many potential causes of problems or issues in an orderly way and in identifying root causes.

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DescriptionThe fishbone diagram identifies many possible causes for

an effect or problem. It can be used to structure a brainstorming session. It immediately sorts ideas into useful categories.

When to Use a Fishbone Diagram •When identifying possible causes for a problem.•Especially when a team’s thinking tends to fall into ruts.

Fishbone Diagram Procedure Materials needed: flipchart or whiteboard, marking pens.

•Agree on a problem statement (effect). Write it at the center right of the flipchart or whiteboard. Draw a box around it and draw a horizontal arrow running to it.•Brainstorm the major categories of causes of the problem. If this is difficult use generic headings:

1.Methods2.Machines (equipment)3.People (manpower)4.Materials

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• Measurement• Environment

3. Write the categories of causes as branches from the main arrow.4. Brainstorm all the possible causes of the problem. Ask: “Why does this happen?” As each idea is given, the facilitator writes it as a branch from the appropriate category. Causes can be written in several places if they relate to several categories.5. Again ask “why does this happen?” about each cause. Write sub-causes branching off the causes. Continue to ask “Why?” and generate deeper levels of causes. Layers of branches indicate causal relationships.6. When the group runs out of ideas, focus attention to places on the chart where ideas are few.

Fishbone Diagram Example

This fishbone diagram was drawn by a manufacturing team to try to understand the source of periodic iron contamination. The team used the six generic headings to prompt ideas. Layers of branches show thorough thinking about the causes of the problem.

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Fishbone Diagram Example For example, under the heading “Machines,” the idea “materials of

construction” shows four kinds of equipment and then several specific machine numbers.

Note that some ideas appear in two different places. “Calibration” shows up under “Methods” as a factor in the analytical procedure, and also under “Measurement” as a cause of lab error. “Iron tools” can be considered a “Methods” problem when taking samples or a “Manpower” problem with maintenance personnel.

Reporter:Edshel Mae B.

Cañeta


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