Basic concepts in nursing science

Li Xiaohan

School of Nursing China Medical University

March, 2005

Introduction
1. Definition of nursing science 2. Four basic concepts that affect and determine the nursing practice (1) Human being (2) Environment (3) Health (4) Nursing

Human being
1. The human being is a uniform whole entirety (1) Concept of a whole (2) The uniform whole of human being 1) Physiological 2) Psychological 3) Social 4) Spiritual 5) Cultural 3. The human being is an open system (open whole) (1) Close system (2) Open system 4. The scope of human being in nursing (1) Individual (2) Family (3) Community (4) Society Basic goal of human being: To maintain the balance of organism (1) Balance among subsystems of an organism (2) Balance between organism and its environment (internal environment and external environment) 2. Basic need of human being (1) Definition of basic need 1) Need 2) Basic need of human being (2) Types of basic need 1) Physiological need 2) Social need 3) Affective need 4) Cognitive need 5) Spiritual need (3) Characteristics of basic need 1) Approximately same basic need
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The importance of each need for each person is different All the basic needs are interconnected and interactive (4) Factors that affect meeting needs 1) Physiological elements 2) Emotional elements 3) Knowledge and intellectual elements 4) Social elements 5) Environmental elements 6) Individual elements 7) Cultural elements (5) The theory related to basic needs Maslows hierarchy theory of Basic needs for Human Being 1) Theorys basic content a) Physiological needs b) Safety needs c) Love and belongingness needs d) Self-esteem needs e) Needs for self-actualization 2) Basis for needs hierarchy a) Importance of needs b) Sequence of needs appearance 3) General rules 4) Significance to nursing a) To identify clients unmet needs b) To realize and understand clients words and behaviors c) To predict clients unspoken needs d) To collect clients data comprehensively in case of missing e) To put clients nursing problems in adequate order 3. Growth and development of human being (1) Definition of growth and development
2) 3)

1) Growtha increase on amount in physiological aspect. a) height b) weight c) age 2) Development: (a)Definition: a changing process in physical and psychological aspect along with ages increase and interaction between individual and its environment. (b) Characteristics of development: a) in order b) predicted c) persistent d) as a result of learning and a symbol of maturation
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e) holistic (physiological, psychological, social ) 3) Maturation: (a) narrow definition: the process of the growth in physiological aspect and the potential in developmental aspect were exerted fully (b) generalized definition: a individual has not only obtained full development in physiological aspect, but also put up many mature behaviors. (2) Content of growth and development 1) Physiological 2) Cognitive 3) Social 4) Affective 5) Spiritual 6) Moral (3) Basic principle of growth and development 1) Persistent, in sequence, regular, predicted . 2) Common development process 3) Passing each developmental stage in unique manner and speed. 4) Character and definite developmental tasks in each developmental stage 5) Development in infant phase will affect the following basic attitude, temperament, life style and behaviors. 6) Development is obtained by gradual maturation and constant learning. (4) Factors that affect growth and development 1) Heredity 2) Environment (a) Family (b) School (c) Other: religion, culture, society, learning, and life experiences 4. Self-concept of human being (1) Definition of self-concept: a persons attitude towards to himself (herself ) (2) Generation of self-concept: the combination of others opinion to a person and a persons self-detection and self-cognition. (3) Components of self-concept 1) Body image (appearance, physical structure, physical function) 2) Role performance 3) Personal identity 4) Self-esteem (4) Importance of a well self-concept 1) Affecting ones thoughts and behaviors
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2) Affecting ones choices 3) Affecting others attitude to oneself 4) Affecting ones ability of meeting an emergency when one is in the face of (affronts)various changes.

Environment
1. Definition of environment (1) Roys definition of environment: the summation of all factors that surround and affect the behaviors and development of individual or collectivity. (2) Hendersons definition of environment: a general name of all external factors that affect the life and development of organism. 2. Classification of environment (1) Internal environment: the environment in the organism (2) External environment 1) Natural environment (entironment) (a) Physical environment: air, water, sunlight, soil (b) Biological environment: animal, plant, microorganism 2) Humanistic-social environment (a) the number of population (b) cultural education (c) interpersonal relationship (d) scientific management (e) medical care services system 3) Therapeutic environment (a) Definition: It is an environment that created by professionals aimed to fit the recovery of clients physiological and psychological health (2) Functions: (a) influencing clients feeling (b) influencing the course and degree of diseases recovery. (3) Requirement: (a)safety a) to prevent the accidents occurrence b) to avoid the spread of microorganism (b)comfort a) good physical environment b) good services and attitude 2. Relationship among environment, human being and health (1) Human being and its environment are interdependent and interacted (2) Human beings health is closely linked with the environment
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Health
1. Concept of health (1) Definition of health 1) Absence of disease 2) Feel comfort 3) Well-balanced functional activities 4) Well-balanced physiological and psychological activities 5) WHO--- The World Health Organization: a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity. (holistic view of health) (2) Models of health --- Health-illness continuum model 1) Definition: Health and illness or disease can be viewed as the opposite ends of a health continuum. From a high level of health a persons condition can move through good health, normal health, poor health, and extremely poor health, eventually to death. People move back and forth within this continuum day by day. There is no distinct boundary across which people move from health to illness or from illness back to health. How people perceive themselves and how others see them in terms of health and illness will also affect their placement on the continuum. 2) Characteristics: (a) At any time any person health status holds a place on certain point between two ends of health-illness continuum (b) any point on the health-illness continuum is a synthetical representation of various (all) aspects of individual in physiology, psychology, and society. 3) Nurses responsibility: (a) to help the clients to identify their place (location) on the health-illness continuum (b) to assist the clients to adopt some measures (take actions)in order to reach a well state of health. (3) Factors that affect health 1) Biological factors: (a)Pathogenic microorganism (b) Biologic-heredity factor (c) Other factors: age, sex, growth and development 2) Environmental factors (a) Natural environment: air pollution, climate, water pollution, soil pollution, radiation, noise.
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(b) Social environment: a) political and economic system in the society b) social and cultural system 3) Life style: 4) Psychological factors Psychological factorsemotion, feelings Physiological function 2. Concept of disease (1) Definition of disease 1) Ancient view of disease (a) Ghosts and gods attach to the body (b) Unbalance between negative and positive 2) Modern view of disease (a) A state that is treated by physician and falls short of the needs of human being (b) Be discomfort, suffering and pain (c) A loss and change of social behaviors, especially the loss and change of labour force (d) An abnormity of function, structure and shape of organism (e) The destroy of homeostasis of organism (f) A reaction of the organism to harmful factors 3) Disease: (2) Effect of disease 1) The effect on individual (a) Positive effect (b) Negative effect: 2) The effect on family (a) Economic burden is increased (b) Family members psychological stress is increased (c) The emotion change of family member 3) The effect on society (a) Social productivity is decreased (b) medical resources are consumed or wasted (c) to infect others and threaten others health (3) Measures of preventing disease 1) Primary prevention (etiological prevention) 2) Secondary prevention (pre-clinical prevention) Three early : To discover early To diagnose early To treat early 3) Tertiary prevention (clinical prevention) 3. The relationship between health and illness
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(1) No distinct boundary. A relative relationship (2) Be dynamic changing (3) Be mutual transform under definite condition (4) Be exist at the same time on one individual

Nursing
1. Concept of nursing (1) Definition of nursing 1) Nightingales definition of nursing 2) Hendersons definition of nursing 3) American Nurse Associations definition of nursing 4) International Council of nurses definition of nursing (2)The content of concept of nursing 1) The nursing science is an independent applying science that synthesizes natural and social science. 2) Nursing is a profession that helps human being and serves for health of human being 3) Nursing can assist individual to meet the basic needs of human being and enforce the ability of self-care. 4) The tasks of nursing are: (a) to promote health (b) to prevent disease (c) to help ill-person to healing (to assist healing) (d) to assist the dying patient to pass away with quietude, peace, and dignity. (to ease suffering) 5) The client is a holistic human being, including suffering person and healthy person. 6) The working place is not only in the hospital, but also in family, community and whole society. 7) Nursing is not only a science, but also an art. 8) The nursing science attaches importance to human beings living environment and the interrelation between human being and its environment. 9) The nursing science is a gradually perfect and developing science. (3) Basic connotation of nursing (core) 1) Caring: lasting topicto provide nursing care to the clients 2) Humanism: humanistic perspective (a) to respect individual (b) to pay attention to the human nature (c) to treat equally without discrimination 3) a helping relationship
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2. Evolvement process of the concept of nursing (1) Developmental stages of nursing model 1) Stage 1: disease-centered stage: to pay attention to the disease not to the person; to follow the physicians order 2) Stage 2: patient-centered stage: to use the nursing process to give the holistic care to the patients----to collect patients data; to make nursing diagnosis; to establish nursing care plan; to implement the nursing care plan; to evaluate the achievement of nursing objectives. Nurses client is merely the ill person and nurses working place is merely in the hospital. 3) Stage 3: health-centered stage: Nurses pay attention to a persons health. Nurses clients include not only ill persons but also healthy persons. Nurses working place is not only in the hospital, but also in the family, community and society. (2) The meaning and significance of holistic nursing 1) The meaning of holistic nursing (a) Definition of holistic nursing (b) Connotation of holistic nursing a) to meet clients holistic needs (physiological, psychological, social, spiritual, cultural ) b) to serve for the whole life course of human being c) to serve for individual, family, community and society 2) Significance of holistic nursing (a) To enrich and change the direction and content of nursing research (b) To widen the service areas of nursing and to change the traditional image of nurses (c) To contribute to establish a new type relationship between physician and nurse, and relationship between nurse and patient (d) To propose a new type view of nursing administration and leadership (e)To change the curriculum design of nursing education 3. The relationship between nursing and health (1) WHO(1978) : to help patient to resume to health , help healthy person to promote health. (2) ICN: right and obligation of nurses is: 1) To maintain life 2) To lighten (decrease) suffering 3) To promote health