Faye-Abdellah-nursing theories education

theory

1. Faye Abdellah 21 NURSING PROBLEMS

2. Background Born - March13.1919 Nursing Diploma from Fitkin Memorial Hospital Columbia University Bachelors Degree in Nursing 1945 Masters Degree in Physiology 1947 Doctorate in Education 1955

3. May 6, 1937 German hydrogen-fueled airship Hindenburg exploded in Lakehurst, New Jersey "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."

4. Accomplishments U.S . Public Health Service (Branch of Military) Chief Nurse Officer First Deputy U.S. Surgeon General Uniformed Services University of Health Sciences Founder and First Dean, Graduate School of Nursing Yale University School of Nursing Nursing Instructor

5. Nursing researcher and theorist “First woman to become a surgeon general as a nurse” Originated from nursing practice & desire to promote patient-centered comprehensive care

6. Faye G. Abdellah’s Theory Abdellah’s theory,  “Nursing is based on an art and science that moulds the attitudes, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help people, sick or well, cope with their health needs.”

7. METAPARADIGM

8. Person Having physical, emotional, and sociological needs. Needs may be OVERT  largely physical needs COVERT  emotional , sociological and interpersonal needs- which are often missed and perceived incorrectly.

9. Nursing Responsibilities Effective communication between patient and caregiver. Information is accurate, timely and appropriate. Do everything possible to alleviate patients’ pain and make them feel comfortable. We provide emotional support and alleviate fears and anxiety. We involve family and friends in every phase of our patients’ care.

10. Patient is described as the only justification for the existence of nursing.

11. Health Does not give a definition of health “ Total health needs” and “a healthy state of mind and body ” in her description of nursing as a comprehensive service.

12. Environment Home or community from which patient comes . Society is included in “planning for optimum health on local, state, national and international levels.”

13. Nursing “Nursing is based on an art and science that mold the attitudes, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help people, sick or well, cope with their health needs ” Comprehensive nursing service

14. Nursing Service to individuals, to families and therefore to society. Goal of nursing is the fullest physical, emotional, intellectual, social and spiritual functioning of the client which pertains to holistic care.

15. 11 Nursing Skills Observation of health status Skills of communication Application of knowledge Teaching of patients and families Planning and organization of work

16. 6. Use of resource materials 7 . Use of personnel resources 8 . Problem-solving 9 . Direction of work of others 10 . Therapeutic use of the self 11 . Nursing procedures

17. Abdellah’s Theory and Nursing Influence Nursing PATIENT Physiologic Sociologic Psychological

18. four categories of patient needs Basic to all patients Sustenal care needs Remedial care needs Restorative care needs.

19. Twenty-One Nursing Problems Serve as a knowledge base for nursing ( Categorized according to needs)

20. ABDELLAH'S TYPOLOGY OF 21 NURSING PROBLEMS BASIC TO ALL PATIENTS 1. To maintain good hygiene and physical comfort – After colonoscopy, patients are usually soiled from the procedure. It is therefore important to clean them properly. Physical comfort through proper positioning in bed. 2. To promote optimal activity: exercise, rest, and sleep – Patients who were sedated during the procedure stay in the unit until the effect of the sedation has decreased to a safe level. As a nurse, make sure the patients are able to rest and sleep well by providing a conducive environment for rest, such as decreasing environmental noise and dimming the light if necessary.

21. 3. To promote safety through prevention of accident, injury, or other trauma and through the prevention of the spread of infection – one way we prevent the spread of infection is through proper disinfection of the equipments . Bed alarm , call light at all times 4. To maintain good body mechanics and prevent and correct deformity – Positioning the patient properly, allowing for the normal anatomical position of body parts.

22. SUSTENAL CARE NEEDS 5. facilitate the maintenance of a supply of oxygen to all body cells – when patients manifest breathing problems, oxygen is attached to them. Sedated patients are attached to cardiac monitor and pulse oxi meter while having the oxygen delivered. When the oxygen saturation falls below the normal levels, the rate of oxygen is increased accordingly, as per physician's order. 6. To facilitate the maintenance of nutrition of all body cells – patients undergoing endoscopic procedures are on NPO. For this reason it is important to monitor the blood glucose level. When the patient's blood glucose falls from the normal value, we inject D50W to the patient or we change the patient's IVF to a dextrose containing fluid.

23. 7. To facilitate the maintenance of elimination – Providing bedpans or urinals to patients and at times, insertion of Foley catheter when the patient is not able to void 8. To facilitate the maintenance of fluid and electrolyte balance – Proper regulation of the intravenous solutions .

24. 9. To recognize the physiological responses of the body to disease conditions—pathological, physiological, and compensatory – ex. Pt. with DENGUE- it is important to check the patients for signs of bleeding by monitoring the BP, capillary refill 10.To facilitate the maintenance of regulatory mechanisms and functions – When a patient has a difficulty in breathing and is showing an increase respiratory rate, elevating the head part of the bed is done to facilitate the respiratory function.

25. 11. To facilitate the maintenance of sensory function – When a patient is admitted who is already deaf and mute, we communicate to them by body language to maintain their basic need despite of inadequacy to the sensory function . Communicate to comatose patient

26. REMEDIAL CARE NEEDS 12. To identify and accept interrelatedness of emotions and organic illness – Encourage patients to verbalize their feelings and allow them to cry when they have the need to do so will help them emotionally. Some patients are diagnosed with malignancy after the procedure and during this time the emotional needs of the patient is a priority.

27. 13. To identify and accept positive and negative expressions, feelings, and reactions – most patients feel anxious before undergoing the procedures. It is necessary to listen to the patients' expressions and allow them to ask questions. to decrease their anxiety.

28. 14. To facilitate the maintenance of effective verbal and nonverbal communication – when patients are not able to express themselves verbally, it is important to assess for nonverbal cues. For instance when patients are in pain, assessing for facial grimacing.

29. 15. To promote the development of productive interpersonal relationships – allow the patient's significant others to stay with the patient before and after the procedure. This allows for bonding and promotes interpersonal relationship.

30. 16. To facilitate progress toward achievement of personal spiritual goals – nurse usually visits the patients in the unit. Patients may benefit from this, allowing them time to practice their faith. 17. To create and/or maintain a therapeutic environment - providing proper lighting, proper room temperature, a quiet environment are done to patients staying in the unit.

31. 18. To facilitate awareness of self as an individual with varying physical, emotional, and developmental needs – care to patients vary according to their developmental needs. Allowing the parents to stay during the procedure help the pediatric patients in their emotional and developmental needs.

32. RESTORATIVE CARE NEEDS 19. To accept the optimum possible goals in the light of limitations, physical, and emotional – The goals for each patient vary depending on the capability of the patient. The nutritional goal for a patient with a PEG tube for instance will be different, knowing that the patient has limited feeding options 20. To use community resources as an aid in resolving problems arising from illness – Some patients live far from the city and thus referral to health centers is sometimes done. support groups for depressed patients Shelter homes for victims of abuse

33. 21. To understand the role of social problems as influencing factors in the cause of illness – Some patients who are diagnosed with amoebic colitis for instance are advised to avoid buying street foods to which the preparation they are not sure of, and also avoid drinking water that are not safe.

34. 10 Ways to Identify a Client’s Problem Learn to know the patient Sort out relevant and significant data Analyze and make generalizations about available data Identify the therapeutic plan Test generalizations with the patient and make additional generalizations Validate the patient’s conclusion about his nursing problems Continue to observe and evaluate the patient over time to identify any attitudes and clues affecting his behavior Explore the patient’s and family’s reaction to the therapeutic plan and involve them in the plan Identify how the nurse feels about the patient’s nursing problems Discuss and develop a comprehensive nursing care plan

35. CHARACTERISTICS Abdellah’s theory has interrelated the concepts of health, nursing problems and problem solving as she attempts to create a different way of viewing nursing phenomenon.

36. LIMITATIONS The major limitation of Abdellah theory and the twenty one nursing problems is their very strong nursing centered orientation. With the orientation appropriate use might be the organization of teaching content for nursing students, the evaluation of a students, performance in the clinical area or both. But in terms of client care there is little emphasis on what the client is to achieve.

37. Using Abdellah’s concepts of health, nursing problems, and problem solving, the theoretical statement of nursing that can be derived is the use of the problem solving approach with key nursing problems related to health needs of people. From this framework, 21 nursing problems were developed. Abdellah’s theory provides a basis for determining and organizing nursing care. The problems also provide a basis for organizing appropriate nursing strategies.