ROYALTY TELEVISION

1. UNIT:4
THEORIES AND MODELS OF NURSING
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2. INTRODUCTION.
 Nursing models provide a knowledge base for
nurses to practice in an efficient manner.
 They provide explicit frames of reference for
professional nursing practice by identifying who
the care recipient is, what the relevant
environment is and what aspects of health are
to be considered.
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3.  The nursing theories on the other hand specify
innovative goals for nursing practice, they also give
ideas to improve practice and coordinate care.
DEFINITION OF KEY TERMS
Model” A symbolic representation of concepts or
variables and interrelation among them” Polit and
Hungler (1995).
Concept “An image or idea held in the mind”
Baillie’re Nurses dictionary (2005).
or
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4.  The nursing theories on the other hand specify
innovative goals for nursing practice, they also give
ideas to improve practice and coordinate care.
DEFINITION OF KEY TERMS
Model” A symbolic representation of concepts or
variables and interrelation among them” Polit and
Hungler (1995).
Concept “An image or idea held in the mind”
Baillie’re Nurses dictionary (2005).
or
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5. A concept is a mental image of event or reality.
Model of Nursing “A systematically
constructed, scientifically based and logically
related set of concepts which identify the
essential components of nursing practice
together with the theoretical basis of
theseconcepts and values required for their use
by the practitioner” (Chalmers and
Aggletone,1986).
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6.  HISTORICAL PERSPECTIVES
 Until fairly recently, nursing science was derived
principally from social, biologic, and medical
science theories.
 However, from the 1950s to the present, an
increasing number of nursing theorists have
developed models of nursing that provide bases
for the development of nursing theories and
nursing knowledge.
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7. Theory is a set of concepts and definitions,
relationships, and assumptions that project a
systematic view of phenomena (Fawcett, 1995).
Nursing theory It is the conceptualization of
some aspects of nursing communicated for the
purpose of describing, explaining, predicting
and or prescribing nursing care (Meleis ,1997).
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8. Nursing theory is a group of related concepts,
definitions & statements that propose a view of
nursing phenomena from which to describe,
explain or predict outcomes.
WHY LEARN THEORIES ?
Theory Guides the Professional
Nurse in;
 Organizing and analyzing patient data
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9.  Understanding connections between pieces of
data.
 Discriminating between important and less
pertinent data.
 Making sound clinical judgments based on
evidence.
 Planning effective nursing interventions.
 Predicting and evaluating outcomes of
interventions.
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10. TYPES OF NURSING MODELS AND THEIR
APPLICATION.
1. OREM’S NURSING MODEL
 Proposed by Dorothea Elizabeth Orem in the
1970s. It is also refered to as the self care model.
 Dorothea Orem’s theory is composed of three
related theories which are theory of self-care,
theory of self-care deficit and the theory of nursing
systems. Orem identified universal self care needs
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11.  which need to be met for an individual to gain,
restore, or maintain health.
 The model is commonly applied/ used in chronic
illness.
A, Theory of self care
 Implies the practice of activities that the individual
initiates and perform on their own behalf in
maintaining life, health and well being.
 Under this theory you address the universal self
care needs.
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12. Universal Self-Care Needs (Requisites)
1.The maintenance of a sufficient intake of air
2. The maintenance of a sufficient intake of food
3. The maintenance of a sufficient intake of water
4. provision of care associated with elimination
processes and excrements.
5. activity balance with rest.
6.The maintenance of balance between solitude
and
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13. social interaction (time spent alone balances
with time spent with others).
7)The prevention of hazards to human life,
human functioning and human well being.
8) Being normal (Maintaining normalcy)
Promotion of human functioning and
development within social groups in accordance
with human potential, known human limitations
and the human desire to be normal.
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14. Self care agency
 You look at the individual’s ability to perform
self care activities. Will the patient manage or
will there be need for a self care agent.
• Self-care Agent – refers to the person who
provides the self care. ( the individual patient,
the nurse or family member).
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15. B. Theory of self care deficit
 Self care deficit provides a guide for the
selection of methods for helping and
understanding the patient’s roles in self care.
 Self care deficit occurs when the demand to
care for oneself is greater than the individual’s
capacity or ability to meet it.
 It is the self care deficit that determines the
need for
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16. nursing care.
 Nursing is required when the client is incapable
of continuous and effective self care.
 Methods of help that can be used in meeting
the self care deficit include;
 Acting or doing for
 Guiding
 Teaching
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17. Supporting
 Providing an environment to promote the
 patient’s ability to meet current or future
demands.
C. Theory of nursing systems
Focus upon;
 The specific roles and responsibilities of the
patient and the nurse in the nurse patient
relationship.
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18.  It specifies/ describes how the client’s self care
needs will be met by the nurse, client or both.
 With this theory, the nurse determines whether
there is a legitimate need for nursing care and if
a self care deficit exists.
 It is also the time when a nurse plans care and
identifies what should be done and who should
do it.
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19.  The nursing system can be wholly
compensatory, partly compensatory or
supportive educative.
 Wholly compensatory - when the nurse or
caregiver does all care for patient. Patient is
unable to care for themselves.
 Partly compensatory –when the patient can do
some care for them self but still relies on the
nurse or caregiver for
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20. assistance.
 Supportive educative -person is able to perform
required self care, but can not do without
assistance .
Key Components of Care
The nature of people
 Orem views a person as a functional integrated
whole with a motivation to achieve self-care.
 For a healthy individual, Orem identified eight
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21.  Universal self care needs that require
satisfaction.
The Causes of Problems Likely to Require
Nursing Interventions
a. Universal needs.
b. Developmental- Conditions that support life
processes and promote specific developmental
stages( Infancy, childhood, adolescence).
c. Health deviations.
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22. a. Nursing intervention is required only when
b. individuals (or their relatives and significant
others) are unable to achieve or maintain a
balance between self care abilities and self-care
demands.
The Nature of the Assessment Process
 Orem Calls assessment ‘investigative operation’
 The Nurse has to assess those demands being
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23. made on the individual for self care.
 Assess also the Individual’s ability to meet these
demands.
 Assess the self care deficit and reasons for it
which could be:
◦ Insufficient knowledge to respond to self care
demands
◦ Insufficient skill to carry out the self care
activities
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24. ◦ Motivation to achieve self care
 Assess whether the individual’s present state
allows for safe involvement in self-care.
 Assess the patient’s potential for re establishing
Self-care in the future.
 Orem emphasises the importance of involving
the patient , family and significant others in the
care.
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25.  The patient or family member should be
involved from the onset of care.
The Nature of the Planning and Goal Setting
 Goals are patient centred.
 Short term, intermediate or long term goals can
be set.
 Negotiate with the patient whether the nursing
interventions should be:
◦ Wholly compensatory – act for the patient
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26. completely
◦ Partly compensatory- share certain tasks with
the patient
◦ Supportive educative – consultative and
facilitative
The Nature of the Process of Evaluating
the Care Given
◦ Evaluated in terms of the patient’s or family’s
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27. subsequent ability to perform self care.
THE ROLE OF THE NURSE.
 Major role is complementary one
 Nurses may intervene in the lives of patients in
order to:
◦ help the individual to sustain health
◦ recover from disease and injury or
◦ cope with the effects of disease and injury.
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28. 2. HENDERSON’S MODEL OF NURSING
 Henderson’s model of Nursing emphasizes the
existence of both biological and psychological
even social needs that can sometimes lead to a
need for nursing care.
 Henderson came up with 14 fundamental needs
for a person to stay healthy.
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29. 14 fundamental needs
1. To breath normally.
2. To eat and drink adequately.
3. To eliminate body waste.
4. To move and maintain desired posture.
5. To sleep and rest.
6. To Select suitable clothing (dress and undress).
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30. 7. To Maintain body temperature within normal
range.
8. To keep body clean and well groomed.
9. To avoid dangers in the environment that cause
injury to ourselves and others.
10. To communicate to others in expressing our
needs, fears and dangers.
11. To worship according to one’s faith.
12. To work in such a way that there is a sense of
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31. accomplishment.
13. To play and participate in social activities/
recreation of your choice.
14. To learn, discover and satisfy curiosity that
lead to normal development and health.
ROLE OF A NURSE
 The role of a nurse is to maintain or restore
independency.
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32. to meet the 14 fundamental needs and help.
 A person can fail to meet the 14 fundamental
needs because of lack of skills, knowledge, will
or strength.
 The nursing intervention will seek to replace,
add, reinforce or increase the strength,
knowledge, skill or will of the client to enable
them meet the 14 fundamentals needs.
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33. 3. NANCY,ROPER& LOGAN THEORY
 This model is focused on activities of living
which can influence man well being.
 It identifies 6 factors which can influence the
health of man.
 These factors are; Biological factors,
Psychological factors, Social-cultural factors,
Environmental factors, Spiritual factors and
Political factors.
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34. The activities of daily living are derived from
these factors.
The Nancy Roper Logan theory is mostly used in
acute care settings.
ACTIVITIES OF DAILY LIVING
 Maintaining a safe environment
 Communicating
 Breathing
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35.  Eating and drinking
 Eliminating
 Personal cleansing and dressing
 Controlling body temperature
 Mobilising
 Working and playing
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36.  Expressing sexuality
 Sleeping
 Dying.
 According to this theory a nurse must be able to
help the client to maintain these activities in
order to fulfill the basic needs.
 The nurse must prioritize the needs of the
patient in relation to the condition.
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