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ASSIGNMENT

ON
ABDELLAH
THEORY

SUBMITTED TO: MS. ASHWINI KADAM

CLINICAL
INSTRUCTOR

M. V. P’S. I. N. E.
ADGAON
SUBMITTED BY: MS.
URVASHI RAI

F. Y. M. Sc.
NURSING

SUBMITTED ON: 18/04/2019


ABDELLAHS THEORY

INTRODUCTION

Faye Glenn Abdellah was one of the most influential nursing theorist and public
health scientists. 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.

BIOGRAPHY

Faye Glenn Abdellah was born on March 13, 1919, in New York

EDUCATIONAL ACHIEVEMENTS

In 1942, Abdellah earned a nursing diploma from Fitkin Memorial Hospitals 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.

AS AN EDUCATOR AND RESEARCHER

Abdellah went on to become a nursing instructor and researcher and helped


transform the focus of the profession from disease centered to patient centered. She
expanded the role of nurses to include care of families and the elderly. She worked in many
settings. She had been a staff nurse, a head nurse, a faculty member at Yale University and
at Columbia University, a public health nurse, a researcher and an author of more than 147
articles and books. She was selected as Deputy Surgeon General in 1982. She retired in
1989.

WHAT HAS INFLUENCED FAYE ADDELLAH IN DEVELOPMENT


OF HER OWN MODEL OF NURSING?

1937 – She wanted to be a nurse on the day she saw Hindenburg explode.

1949 – She spent 40 years in Public Health Service where she first became involved in
research, being assigned to perform studies to improve nursing practices.
1960 – She was influenced by the desire to promote client- centered comprehensive nursing
care.

ABDELLAHS 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 these dation 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.
3. To promote safety through prevention of accident, injury, or other trauma and through
the prevention of the spread of infection – Making sure the side rails are always up
when leaving the patient .one way we prevent the spread of infection is through proper
disinfection of the equipment’s .
4. To maintain good body mechanics and prevent and correct deformity – Positioning the
patient properly, allowing for the normal anatomical position of body parts.

SUSTENTIAL CARE NEED

5. To facilitate the maintenance of a supply of oxygen to all body cells –when patients
manifest breathing problems, oxygen is attached to them, usually via nasal cannula.
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 physicians 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 patients IVF to a dextrose containing fluid.
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 as well as proper incorporations it may have. An example is when
patients have low serum potassium; KCl is incorporated in the solution.
9. To recognize the physiological responses of the body to disease conditions—
pathological, physiological, and compensatory – it is important to check the patients for
signs of internal gastrointestinal bleeding by monitoring the blood pressure and cardiac
rate.
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.
11. To facilitate the maintenance of sensory function –Sometimes there are semi-conscious
patients, in these cases, itis still necessary to talk to them while performing nursing
interventions to maintain their auditory sense.

REMEDIAL CARE NEED

12. 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, proper
instructions are given, what they are to expect, how long the procedure will take, what
they should do during and after the procedure as well as other concerns.
13. 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.
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.
15. To promote the development of productive interpersonal relationships – Allow the
patients significant others to stay with the patient before and after the procedure. This
allows for bonding and promotes interpersonal relationship.
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.
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 paediatric patients in their
emotional and developmental needs.

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.
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.

ASSUMPTION
 The language of Abdellah’s framework is readable and clear.
 Consistent with the decade in which she was writing, she uses the term ‘she’ for
nurses, ‘he’ for doctors and patients.
 Assumptions are related to
 Change and anticipated change that affect nursing.
 The need to appropriate the interconnectedness of social enterprises and social
problem.
 The impact of problems such as poverty, racism, pollution, education and so forth on
health care delivery.
 Correct identification of nursing problems influences the judgment in selecting the
next step in solving the client nursing problems.
CONCEPTS

MAN/ PERSON

by Unknown Author is
HEALTH
licensed under
NURSE
D

ENVIRONMENT

1. MAN/PERSON:- Abdellah describes people as having physical, emotional, and


sociological needs. These needs may overt, consisting of largely physical needs, or
covert, such as emotional, sociological and interpersonal needs – which are often
missed and perceived incorrectly.
 The individuals (and families) are the recipients of nursing, and health, or achieving of
it, is the purpose of nursing services.
2. HEALTH:- In patient – centered approaches to nursing, Abdellah describes health as a
state mutually exclusive of illness.
 Although Abdellah does not give a definition of health, she speaks to ‘total health
needs’ and ‘a healthy state of mind and body’ in her description of nursing as a
comprehensive services.
3. ENVIRONMENT/SOCIETY:- The environment is implicitly defined by Abdellah as
the home or community from which patient comes.
 Society in included in “planning for optimum health”. However, as Abdellah further
delineated her ideas, the focus of nursing service is clearly the individual.
4. NURSING:- Nursing is a helping profession. These would mean a comprehensive
nursing service, this would include:
 Recognizing the nursing problems of the patient.
 Deciding the appropriate actions to take in terms of relevant nursing principles.
 Providing continuous care of the individual’s total health needs.
 Providing continuous care to relieve pain and discomfort.
 Adjusting total nursing care plan to meet the patient’s individual needs.
 Helping the individual to become more self directing in attaining or maintaining a
healthy state of mind and body.
 Instructing nursing personnel and family to help the individual.
 Helping the individual to adjust to his limitations and emotional problems.
 Working with allied health professional in planning for optimum health.

STEPS TO IDENTIFY THE CLIENT’S PROBLEM

 Learn to know the patient


 Sort out relevant and significant data
 Make generalizations about available data in relation to similar nursing problems
presented by other patients
 Identify the therapeutic plan
 Validate the patient's conclusions about his nursing problems

NURSING SKILLS

 Observation of health status


 Skills of communication
 Application of knowledge
 Teaching of patients and families
 Planning and organization of work
 Use of resource materials
 Use of personnel resources
 Problem solving
 Direction of work of others
 Therapeutic use of the self
 Nursing procedure.

PURPOSES
1) NURSING PRACTICE:-
o Abdellah’s main goal is the improvement of the nursing education.
o The most important impact of Abdellah's theory to the nursing practice is that it
helped transform the focus of the profession from being ‘disease- centered’ to
‘patient - centered’.
o The steps of the nursing process are assessment, diagnosis, planning,
implementation and evaluation.
2) NURSING EDUCATION:-
o Professors and educators realized the importance of client centered care rather than
focusing on medical interventions.
o Nursing education then slowly deviated its concentration from the complex,
medical concepts, into exercising better attention to the client as the primary
concern.
o It’s very strong nurse- centered orientation- is, on the other hand, it’s major
contribution to nursing education.
3) NURSING RESEARCH:-
o Her theories continue to guide researchers to focus on the body of nursing
knowledge itself, the identification of patient problems, the organization of nursing
interventions, the improvement of nursing education, and the structure of the
curriculum.
o The extensive research done regarding the patient’s needs and problems has served
as a foundation for the development of what is now known as nursing diagnosis.
USE OF 21 PROBLEMS IN THE NURSING PROCESS

NURSING
ASSESSMENT

EVALUATION DIAGNOSIS
NURSING
PROCESS

IMPLEMENT
PLANNING
ATION

1. ASSESSMENT PHASE: -
Nursing problems provide guidelines for the collection of data.
A principle underlying the problem-solving approach is that for each identified problem,
pertinent data are collected.
The overt or covert nature of the problems necessitates a direct or indirect approach,
respectively.
2. NURSING DIAGNOSIS: -
The results of data collection would determine the client’s specific overt or covert
problems.
These specific problems would be grouped under one or more of the broader nursing
problems the step is consistent with that involved in nursing diagnosis.
3. PLANNING PHASE: -
The statement of nursing problem most closely resembles goal statements. Once the
problem has been diagnosed, the nursing goals have established.
4. IMPLEMENTATION: -
Using the goals as the framework, a plan is developed and appropriate nursing
interventions are determined.

5. EVALUATION: -
The most appropriate evaluation would be the nurse progress or lack of progress toward
the achievement of the stated goals.

CHARACTERISTICS
CHARACTERISTIC 1: - 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.
CHARACTERISTIC 2: - Problem solving is an activity that is inherently logical in
nature.
CHARACTERISTIC 3: - Framework seems to focus quite heavily on nursing practice
and individuals. This somewhat limits the ability to generalize although the problem the
problem-solving approach is readily generalizable to clients with specific health needs
and specific nursing problems.
CHARACTERISTIC 4: - One of the most important questions that arise when
considering her work is the role of client within the framework. This question could
generate hypothesis for testing and thus demonstrates the ability of Abdellah's work to
generate hypothesis for testing.
CHARACTERSTIC 5: - The results of testing such hypothesis would contribute to the
general body of nursing knowledge.
CHARACTERSTIC 6: - Abdellah’s problem solving approach can easily be used by
practitioners to guide various activities with in their practice. This is true when
considering nursing practice that deals with clients who have specific needs and specific
CHARACTERSTIC 7: - Although consistency with other theories exist, many questions
remain unanswered.

LIMITATIONS
The major limitation of Abdellah theory and the twenty-one nursing problems is
their very strong 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.

CONCLUSION
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 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.
BIBLIOGRAPHY
1. Samta Soni, Advanced Nursing Practice, Jaypee Brothers, Medical Publishers, 1st
Edition, Pg. No.
2. Shebeer. P. Basheer, A Concise Textbook Of Advanced Nursing Practice, Emmess,
2nd Edition, Pg.No.