TFN Finals Part 01 (Notes)

Nursing Conceptual Models

Are comprehensive nursing theories that address the nursing metaparadigms and explain the relationship between them

Florence Nightingale

Founder of Environmental Theory & Modern Nursing

Florence Nightingale

Defined nursing as “the act of utilizing the environment of the patient to assist him in his recovery”

Florence Nightingale

Stated that nursing “ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet and the proper selection and administration of diet”

Five environmental factors from the Environmental Theory

Fresh air, pure water, effecient drainage, cleanliness or sanitation and light/ direct sunlight

Theory

Organized system of concepts that are interrelated and undergo testing to know what it is all about; relationships are proposed to predict outcome of the study/ theory presented

Components of a Theory

Concepts, relationship statements, assumptions, conceptual model/ framework, phenomenon

Concept

Elements or building blocks of a theory

Types of concepts

Abstract concept, concrete concept

Abstract concept

Not specific in terms of time and place

Concrete concept

Specific as to time and place

Relationship statements

A statement of relationships between two or more components

Types of relationship statements

Proposition, hypothesis, laws

Proposition

Explains relationship between concepts

Hypothesis

Alternative suggestions; up for testing; proposed explanation for a situation;

Laws

Validated statements; a statement of fact meant to describe a set of action

Assumption

Beliefs and accepted truth

Conceptual Model/ Framework

Symbolic representation or mental/ visual image of a phenomenon; Interactional Model by Hildegard Peplau

Phenomenon

Designation of an event; part of reality that can be consciously

Stages of theory development

(1) silent knowledge stage, (2) received knowledge stage, (3) subjective knowledge stage, (4) procedural knowledge stage, (5) constructed knowledge stage, (6) integrated knowledge stage

Silent Knowledge Stage

blind obedience to medical authority; Aseptic Technique was introduced; education and practice were based on tradition, rules, principals, and focused on technical skills

Aseptic Technique

Handwashing, wearing of masks, gloves or gowns

Received Knowledge Stage

People started to listen to others; used borrowed theories to guide nursing education and research; had the first Nursing Research Journal

Subjective Knowledge Stage

More nursing leaders and theorists emerged; through researches made, a authority and new sense of worth was made

Procedural Knowledge Stage

Led into the identification of common elements of Nursing or Metaparadigms; more nursing theories/researches were published

Constructed Knowledge Stage

A combination of different types of knowledge and information; make up a more complex knowledge stage

Integrated knowledge stage

Assimilation and application of evidences; evidence-based practice; with emphasis on empirical studies, literature, and clinical experiences

2 approaches in the classification of theories in nursing

Scope of theory, type/ purpose of theory

Types under the Scope of Theory

metatheory, grand theory, middle-range theory, practice theory

Scope of Theory

Deals with a range of abstractness of a model

Metatheory

Focuses on broad issues that will help in generating knowledge and theory development

Grand Theory

Considered most complex and broad in scope, non-specific, and relatively abstract concept that lacks operational definition; propositions are abstract/ vague therefore cannot be tested

Middle-Range Theories

Substantively specific and includes a limited number of concepts; concepts are operationally defined

Practice Theory

Situation-specific theory/ perspective theory/ micro theory

Practice Theory

Will guide nursing practice; determines the specific population where the model can be applied; application is for a specific field of practice

Kinds of the Type/ Purpose of Theory

Descriptive/ Factor- Isolating Theory, Explanatory/ Factor- Isolating Theory, Predictive/ Situation- Producing Theory

Descriptive/ Factor-Isolating Theory

Describes or observes or labels and names the concepts, properties, and the dimension of a theory

Descriptive/ Factor-Isolating Theory

Limited to identifying or naming concepts; doesn't explain why or how the concepts are related

Explanatory/ Factor- Relating Theory

Observing relational statements that show interrelationships; propositioned are specific among some concepts; will show specific association

Prescriptive/ Situation-Producing Theory

There is an order of things to do; refers to those prescribed activites needed to attain desired goals

Prescriptive/ Situation-Producing Theory

Deals with nursing therapeutics; most difficult to identify in the review of literature; spells out from A-z what needs to be done

Predictive/ Situation- Relating Theory

Assumptiond are directly spelled out/ stated; the relationship statements can describe the future outcomes consistently

Metaparadigms

Most abstract and general component of the hierarchy of nursing knowledge; world views of a discipline; serves as an ongoing framework

Metaparadigms

Philosophical orientation which a conceptual development is proceeded; the umbrella of where nursing practice is all about;

Metaparadigms

Summarizes the intellectual and social missions of the discipline

Requirement of a Metaparadigm

Must identify a domain that is distinctive from others

Requirement of a Metaparadigm

Must encompass all phenomena of interest to the discipline globally

Requirement of a Metaparadigm

Must be perspective neutral or must be applicable or true to all

Requirement of a Metaparadigm

Must be global in scope and substance rather than reflecting particular beliefs/ values nationally

Requirement of a Metaparadigm

Nonspecific to a particular nation or culture

Definition of Health (WHO)

“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”

General System Theory

An open system developed in 1930; composed of both structural and functional components

Living system

An open system with the ongoing exchange of matter, energy, and information

Basic Assumption/ Tennet of the General System Theory

A system is composed of subsytems each with its own functions

Basic Assumption/ Tennet of the General System Theory

A system contains enery, matter, and information

Basic Assumption/ Tennet of the General System Theory

A system may be an open or closed system

Basic Assumption/ Tennet of the General System Theory

Open and closed system usually attain stationary status

Open system

A system that allows the exchange of energy, matter, and information

Closed System

A system that show clearly defined boundaries

Common Elements in a System

Input, throughput, output, feedback

Input

Refers to energy, matter, and information received from the environment

Throughput

Refers to energy, matter, and information modified or transformed in a system

Output

Refers to energy, matter, information that is released from the system into the environment

Feedback

Refers to information regarding environmental responses used by the system; may positive, negative, or neutral

Essential for the survivial of living systems

Balanced internal and external environment (equilibrium)

Equilibrium

Is dependent on the system's ability to regulate input and output to attain a balanced relationship of interactive parts (thus performing adaptation in the process)

Adaptation

A mechanism needed to attain or maintain equilibrium; process of accepting or rejecting matter, energy, information by accomodating input or output and modifying the system's response

Erikson Developmental Theory

Shared theory from the behavioral sciences; contributed the 8 stages of life from birth to death

Infancy

Birth to 18 months; trust vs. mistrust

Early Childhood

18 months - 3 years old; autonomy vs. shame & doubt

Late Childhood

3 yrs. - 5 yrs. old; initiative vs. guilt

Schooler

6 - 12 yrs. old; industry vs. inferiority

Adolescence

12- 18 yrs. old; identity vs. identity confusion

Young Adult

18 - 24 yrs. old; intimacy vs. isolation

Middle Adult

25 - 65 yrs. old; generativity vs. stagnation

Old Adult

65 yrs. old above; integrity vs. despair

Maslow’s Hierarchy of Needs

The person has the capacity for self-actualization within himself; he has the potential for growth, creativity, and health; the person must be an activie participant of growth and development

Hierarchy of Needs

Physiologic needs, safety needs, love & belonging needs, self-esteem needs, self-actualizing needs, self-transcendent needs (spiritual growth)

2 subdivisions of the Maslow's Needs

D- motives, B-motives

D-motives

Deficiency needs essential to human survival (needs 1-3)

B - motives

High level needs (if you attained needs 4-5, you have growth potential)

Professional Ethics for Nurses

Essential as nurses should know how one should behave

Ethics

Statement of priciples that will guide nurses on what they should be doing

Morals

Set of standards of behavior; guides nurses on insights & avoiding what is wrong

Values

Importance of a particular subject & object

Conduct

Manner of behavior

Code of Ethics accdg. to the International Council for Nurses (ICN)

Nurses & People, Nurses & Practice, Nurses & Profession, Nurses & Co-workers

Nurses & People

The primary responsibility of nurses to people is to provide nursing care

Nurses & Practice

The nurse is personanally accountable of the nursing practice and will uphold the uniform with dignity and pride

Nurses & the Profession

The nurse is responsible in improving the face of the profession by doing research and practicimg evidence-based practice

Nurse & Co-workers

The nurse has responsibility in encouraging a harmonious relationship among colleagues and the healthcare team

Philippine Code of Ethics

Formulated by the Philippine Board of Nursing; Resolution No.220 Series of 2004

Section 1 of the Phil. Code of Ethics

states that “Health is a fundamental right for everyone/ every individual

Section 1 of the Phil. Code of Ethics

Primary responsibility of the nurse is to prevent health at all cost

Primary responsibility of the nurse is to prevent health at all cost

Prevention of illness ( jealthy lifestyle, primary prevention, screening, vaccination)

Primary responsibility of the nurse is to prevent health at all cost

Alleviation of sufferings ( medications, secondary prevention)

Primary responsibility of the nurse is to prevent health at all cost

Restoration of health ( reconstitution tertiary prevention)

Primary responsibility of the nurse is to prevent health at all cost

Assistance towards a peaceful death ( Abakin & Henderson’s ‘eaeliest assistance to a peaceful death

Section 2 of the Phil. Code of Ethics

Nurses have to gain an understanding and knowledge of man's culture, social, physiological, spiritual, psychological, and ecological aspects of illness, utilizing the therapeutic process of the Nursing process

Patient’s Bill of Rights

Issued by the Department of Health; set of duties and responsibilities