Faye Abdellah Theory of 21 Nursing Problems

Theory of 21 Nursing Problems

1. FAYE ABDELLAH 21 NURSING PROBLEMS THEORY

2. THE LIFE OF ABDELLAH (1919-2017) March 13, 1919: was born in New York to a father of Algerian heritage and a Scottish mother. On May 6, 1937, the German hydrogen-fueled airship Hindenburg exploded over Lakehurst. EDUCATION 1940s - earned a nursing diploma from Fitkin Memorial Hospital’s School of Nursing , now known as Ann May School of Nursing. Went on to earn three degrees from Columbia University - Bachelor of Science degree in Nursing 1947 – Master of Arts degree in Physiology, 1955 - Doctor of Education degree

3. Career and Appointments Educator 1945-1949 - faculty of Yale University She was required to teach a class called “120 Principles of Nursing Practice,” using a standard nursing textbook published by the National League for Nursing The book included guidelines that had no scientific basis, which challenged Abdellah to explain everything she called the “brilliant” students. 2. RESEARCHER 1949 - joined the Public Health Service Her first assignment was with the division of nursing that focused on research and studies. They performed studies with numerous hospitals to improve nursing practice. Nursing education, she argued, should be based on research. 1957, Abdellah spearheaded a research team in Manchester, Connecticut , that established the groundwork for what became known as progressive patient care .  - In this framework, critical care patients were treated in an intensive care unit, followed by a transition to immediate care and then home care. THE LIFE OF ABDELLAH (1919-2017)

4. Career and Appointments 3. Military Nursing Service - 1949 to 1989 - 40-year career as a Commissioned Officer in the U.S. Public Health Service  Assigned to work with the Korean people during the Korean War. She was alternatively assigned to Japan, China, Russia, Australia, and the Scandinavian countries to identify the Public Health Service’s role in dealing with various health problems. - 1970 to 1987 - served as Chief Nurse Officer from and was the first nurse to achieve the rank of a two-star Flag Officer - 1982 to 1989- named by U.S. Surgeon General C. Everett Koop as the first woman and  nurse Deputy Surgeon General . After retirement, Abdellah founded and served as the first dean in the Graduate School of Nursing, GSN, Uniformed Services University of the Health Sciences (USUHS). THE LIFE OF ABDELLAH (1919-2017)

5. OTHER WORKS AND AWARS She also served as a research consultant to the World Health Organization. She has been active in professional nursing associations and is a prolific author, with more than 150 publications. (incl. Better Nursing Care Through Nursing Research and Patient-Centered Approaches to Nursing. ) She also developed educational materials in many areas of public health, including AIDS, hospice care, and drug addiction. in 1994, was named a “living legend” by the American Academy of Nursing. In 2000, was inducted into the National Women’s Hall of Fame for a lifetime spent establishing and leading essential health care programs for the United States. In 2012, Abdellah was inducted into the American Nurses Association Hall of Fame for a lifetime of contributions to nursing. Her contributions to nursing and public health have been recognized with almost 90 professional and academic honors. THE LIFE OF ABDELLAH (1919-2017)

6. Abdellah’s 21 Nursing Problems Theory According to Faye Glenn Abdellah’s theory,  “Nursing is based on an art and science that molds 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.” “Twenty-One Nursing Problems Theory”  that has interrelated the concepts of health , nursing problems , and problem-solving . She used   Henderson’s 14 basic human needs  and  nursing research  to establish the classification of nursing problems. The patient-centered approach to nursing was developed from Abdellah’s practice, and the theory is considered a human needs theory.

7. 1. Person: All persons have self-help abilities and the capacity to learn, both of which vary from one individual to another 2. Health: A state when the individual has no unmet needs and no anticipated or actual impairments 3. Environment: Included in “planning of optimum health on local, state, national, and international levels” 4. Nursing: An all-inclusive service that is based on the discipline of art and science that serves individuals, sick or well, cope with their health needs METAPARADIGM OF NURSING

8. Health “total health needs” and “a healthy state of mind and body.” Health may be defined as the dynamic pattern of functioning whereby there is a continued interaction with internal and external forces that results in the optimal use of necessary resources to minimize vulnerabilities. MAJOR CONCEPTS Nursing Problems The client’s health needs can be viewed as problems, overt as an apparent condition , or covert as a hidden or concealed one. Because covert problems can be emotional, sociological, and interpersonal in nature, they are often missed or misunderstood . Yet, in many instances, solving the covert problems may solve the overt problems as well. Problem Solving The problem-solving process can meet these requirements by identifying the problem, selecting pertinent data, formulating hypotheses, testing hypotheses through collecting data, and revising hypotheses when necessary based on conclusions obtained from the data.

9. TYPOLOGY OF 21 NURSING PROBLEMS

10. To maintain good  hygiene  and physical  comfort . To promote optimal activity: exercise, rest,  sleep To promote safety by preventing accidents, injuries, or other  trauma  and preventing the spread of  infection . To maintain good body mechanics and prevent and correct the deformity. To facilitate the maintenance of a supply of  oxygen  to all body cells. To facilitate the maintenance of  nutrition  for all body cells. To facilitate the maintenance of elimination. To facilitate the maintenance of fluid and electrolyte  balance . To recognize the physiologic responses of the body to disease conditions—pathologic, physiologic, and compensatory. To facilitate the maintenance of regulatory mechanisms and functions. To facilitate the maintenance of sensory function. To identify and accept positive and negative expressions, feelings, and reactions. To identify and accept interrelatedness of emotions and organic illness. To facilitate the maintenance of effective verbal and  nonverbal communication . To promote the development of productive interpersonal relationships. To facilitate progress toward achievement and personal spiritual goals. To create or maintain a therapeutic environment. To facilitate awareness of self as an individual with varying physical, emotional, and developmental needs. To accept the optimum possible goals in the light of limitations, physical and emotional. To use community resources as an aid in resolving problems that arise from an illness. To understand the role of social problems as influencing factors in the cause of illness. Abdellah’s 21 Nursing Problems

11. A. BASIC TO ALL PATIENT NEEDS 1 2 3 4

12. B. SUSTENAL CARE NEEDS 5 6 7 8 9 10 11

13. C. REMEDIAL CARE NEEDS 12 13 14 15 16 17 18

14. D. RESTORATIVE CARE NEEDS 19 20 21

15. Problem-solving Method 10 Steps to identify the Patient’s Problem Learn to know the patient. Sort out relevant and significant data. Make generalizations about available data concerning similar nursing problems presented by other patients. Identify the therapeutic plan. Test generalizations with the patient and make additional generalizations. Validate the patient’s conclusions about his nursing problems. Continue to observe and evaluate the patient over a period of time to identify any attitudes and clues affecting his or her behavior. Explore the patient and their family’s reactions to the therapeutic plan and involve them in the plan. Identify how the nurses feel about the patient’s nursing problems. Discuss and develop a comprehensive  nursing care plan .

16. ABDELLAH’S 11 NURSING SKILLS Observation of health status S kills of  communication Application of knowledge T he  teaching of patients  and families P lanning and organization of work Use of resource materials U se of personnel resources P roblem-solving T he direction of work of others T herapeutic uses of the self Nursing procedure

17. THEORY FRAMEWORK Abdellah’s theory introduces a shift in focus from disease-centered approach to nursing-centered care, aiming to emphasize restorative and preventive measures to meet the total needs of the client. This shift seems to create a pendulum swing, placing nursing at one extreme and leaving client somewhat in the middle. It reflects Abdellah’s intention to redefine the relationship between nursing practice nd holistic client care.

18. APPLICATIONS Nursing Practice The theory outlines a systematic approach to patient care, encompassing the five essential stages: A ssessment, Nursing D iagnosis, P lanning, I mplementation , and E valuation (ADPIE) In the  assessment phase , the nursing problems implement a standard procedure for  data collection . A principle underlying the problem-solving approach is that for each identified problem, pertinent data is collected. The overt or covert nature of problems necessitates a direct or indirect approach, respectively. The outcome of the collection of data in the first phase concludes the patient’s possible problems, which can be grouped under one or more of the broader nursing problems. This will further lead to the  nursing diagnosis . After formulating the diagnosis, a  nursing care plan   is developed, and appropriate   nursing interventions  are determined. The nurse now sets those interventions in action, which complete the implementation phase of the nursing process. The  evaluation  takes place after the interventions have been carried out. The most convenient evaluation would be the nurse’s progress or lack of progress toward achieving the goals established in the planning phase.

19. APPLICATIONS B. Nursing Research Her noteworthy contributions to the development of nursing theory involves a systematic analysis of research reports, resulting in the formulation of 21 nursing problems that provides guidance for comprehensive nursing care. This typology evolved over time, finding a place in the publication of “ Preparing for Nursing Research in the 21 st Century: Evolution, Methodologies, and Challengers” The 21 nursing problems transitioned into a second-generation development known as patient problems and patient outcomes. C. Nursing Education The theory stands as a pioneering contribution to nursing science particularly in the endeavors to transform nursing education. Theory not only developed typology outlining various nursing treatments and skills but also articulated a set of characteristics that distinctly defined nursing. Thus , delineate the nursing profession from other health-related disciplines.

20. ACTIVITY THERE are 10 scenarios provided. Using Abdellah’s theory, provide which of the typologies of 21 nursing problems is appropriate for the scenarios. Group yourself into 10. 1 group will have 1 scenario.

21. QUIZ No. 1 STRICTLY NO ERASURES Part I – Identification (5 items) The 21 Nursing Problems Theory adapted from which Theorist? Year when Faye Abdellah earned her Doctor of Education degree . The term for hidden or concealed health problems in Abdellah’s theory. Name of the research framework where critical patients are treated in ICU, then moved to immediate care, then home care. The first woman and nurse to become Deputy Surgeon General of the United States.

22. Part II – Multiple Choice (15 items) Choose the correct answer. Faye Abdellah was born on: A. April 15, 1920 B. March 13, 1919 C. June 1, 1925 D. May 6, 1937 Abdellah earned her nursing diploma from: A. Columbia University B. Yale University C. Fitkin Memorial Hospital’s School of Nursing D. University of Michigan Which war did Abdellah serve in through the U.S. Public Health Service? A. World War I B. Korean War C. Vietnam War D. Gulf War Which of the following is NOT part of the metaparadigm of nursing according to Abdellah? A. Person B. Health C. Disease D. Environment According to Abdellah, health is: A. Absence of disease B. When the individual has no unmet needs C. A fixed state D. Only physical well-being The 21 Nursing Problems are classified under: A. Basic, Sustenal , Remedial, Restorative B. Physical, Psychological, Emotional C. Primary, Secondary, Tertiary D. Assessment, Planning, Implementation Which typology includes “To maintain good hygiene and physical comfort”? A. Restorative Care Needs B. Basic to All Patient Needs C. Remedial Care Needs D. Sustenal Care Needs Which of the following is an example of a covert problem ? A. Broken leg B. Pneumonia C. Anxiety and fear D. Fever Which step in Abdellah’s problem-solving method involves testing generalizations with the patient? A. Step 2 B. Step 4 C. Step 5 D. Step 8 Which nursing skill refers to the use of self in a therapeutic way ? A. Communication skills B. Therapeutic uses of the self C. Problem-solving D. Observation of health status

23. Abdellah served as Chief Nurse Officer from: A. 1949–1989 B. 1970–1987 C. 1982–1989 D. 1957–1970 Which of the following is NOT one of Abdellah’s 11 nursing skills? A. Application of knowledge B. Teaching of patients and families C. Surgical intervention D. Planning and organization of work In 1994, Abdellah was recognized as a “living legend” by: A. National Women’s Hall of Fame B. American Nurses Association C. World Health Organization D. American Academy of Nursing The main focus of Abdellah’s theory is: A. Disease-centered care B. Patient-centered care C. Technology-centered care D. Hospital-centered care Which of the following is part of Remedial Care Needs ? A. To identify and accept expressions and feelings B. To facilitate sensory function C. To create a therapeutic environment D. To maintain regulatory mechanisms Part III – Enumeration (5 items) 21–23. Give three examples of Sustenal Care Needs in Abdellah’s 21 Nursing Problems. 24–25. Give two examples of Restorative Care Needs in Abdellah’s 21 Nursing Problems.

24. Answer Key Identification Virginia Henderson 1955 Covert problems Progressive patient care Faye Glenn Abdellah Multiple Choice 6. B 7. C 8. B 9. C 10. B 11. A 12. B 13. C 14. C 15. B 16. B 17. C 18. D 19. B 20. A Enumeration 21–23. Examples: To facilitate the maintenance of a supply of oxygen to all body cells To facilitate the maintenance of nutrition for all body cells To facilitate the maintenance of elimination To facilitate the maintenance of fluid and electrolyte balance 24–25. Examples: To use community resources as an aid in resolving problems from illness To understand the role of social problems as influencing factors in illness