THEORETICAL FOUNDATION OF

NURSING PRACTICE
THEORY:
A theory is a set of concepts, definition relationship and assumption that
project a systematic view of phenomena.


A Nursing theory is a conceptualization of some aspect of nursing
communicated for the purpose of describing, explaining, predicting
and / or prescribing nursing care(Maleis 1997)
Components of Theory:

Concepts Definitions







Assumptions
(or)
Propositions

Phenomenon
Concepts:
A theory consists of interrelational concepts. Concepts
are mental formulation of an object (or) event that come from
individual perceptual experience ( Alligood & marriner tomey
2002)



Definitions:
The definitions with in the descriptions of a theory
convey the general meaning of the concepts in a manner that
fits the theory.


Assumptions :

Assumptions are statements that describe
concepts (or) connect two concepts that are factual.



Phenomenon:
A fact (or) situation that is observed to exist
(or) happen.

NURSINGS PARADIGM:

According to Fawcett, a conceptual model consists of four
concepts which are generally considered central to the discipline of Nursing.
This serves as an organizing frame work around which conceptual
development proceeded
Person


Health


Environment/Situation



Nursing
Person:
Refers to the recipient of nursing care, including individual clients,
families and the community.

Health:
It is defined in different way by the client, the clinical setting and the
healthcare profession.

Environment / Situation: It includes all possible conditions affecting the
client and the setting is which health care needs occur.

Nursing:
It is the diagnosis and treatment of human responses to actual (or)
potential health problem (ANA 1995)










Classification of theories in Nursing

According to range/scope/abstractness, theories are classified in to

1) Meta theories
2) Grand theories
3) Middle range theories
4) Practice theories

1) Meta theories
Meta theories describe the philosophical basis of the
discipline. Focuses on broad issues such as the processes of
generating knowledge & theory development.

2) Grand theories
This describes the comprehensive conceptual
framework. There are the most complex and broadest in
scope. They attempt to explain broad area within a discipline
and may incorporate numerous other theories.
3) Middle range theories
Middle range theory lies between the nursing models and more
circumscribed, concrete ideas (practice theories)
Middle range theories are substantively specific and encompass a
limited number of a real world.


4)Practice theories
Practice theories are also called micro theories, prescriptive
theories (or) situation theories


FAYE GLENN ABDELLAHS TYPOLOGY
OF NURSING PROBLEM
(Patient centered approaches to Nursing)
(Twenty one Nursing problems)


Introduction:


Abdellah was motivated to develop her typology by a desire to
promote comprehensive, client centered nursing care.
She used the problem solving approach
Her typology of nursing problem was first published in 1960 in patient
centered approaches to nursing




Concept of Abdellahs Theory

Abdellahs theories would state that nursing is the
use of the problem solving approach based on the three major
concepts of health, nursing problems and problem solving.
Health
She defined health as the dynamic pattern of functioning whereby
there is a continued interaction which internal and external force that results
in the optional use of necessary resources that serve to minimize
vulnerabilities


Nursing Problems
It may be overt as an apparent condition or convert as a hidden (or)
concealed one. Because convert problems can be emotional, Sociological and
interpersonal in nature, they are often missed (or) perceived incorrectly

Problem solving
Quality professional Nursing care requires that nurses
be able to identify & solve, overt & convert nursing problems.
This can be accomplished by problem solving approach. it
involves
Indentifying the data
Selecting pertinent data
Formulating Hypotheses
Testing Hypotheses through the collection of data
Revising Hypotheses

Focus of care pendulum



Nursing Disease
Centered Centered



Client centered




Abdullahs 21 Nursing problems

1)Adequate Hygiene & Physical comfort

2)Optimal activity : exercise, rest and sleep

3)Safety by preventing accidents , injury or other trauma and by preventing
the spread of infection.

4) Good body mechanics and prevention and correction of deformities

5) Adequate O2 supply to all body cells





6) Nutrition for all body cells

7) Elimination

8) ) Fluid & electrolyte balance

9) Recognition of the bodys physiologic responses to disease
(pathological, physiological &compensatory)

10) Maintenance of Regulatory mechanisms &functions






11) Sensory function

12) Identification and acceptance of (+)ve and (-)ve expression, feelings and
reactions

13) Identification & acceptance of the interrelatedness of emotions and organic
illness

14) Effective verbal and nonverbal communications.

15) Productive IPR (interpersonal relationship)

16) Progress toward personal spiritual goals.






17) A therapeutic environment

18) Awareness of oneself as an individual with varying physical, emotional and
developmental needs .

19)Acceptance of the optimum possible goals in light of physical and emotional
limitations

20) Community resources as an aid in resolving problems arising from illness

21) Understanding of social problems as influencing factors in illness






Abdellahs typology and the four concepts of the nursing metaparadigm

a) Person:
1) It is described by Abdellah as one who has physical, emotional
(or) sociological need, helping a person with these need is nursings only
justification.
2) He is the recipient of nursing care
3) Includes families as well as individuals
4) He Is capable of learning and self-help to varying degrees


b) Environment :
1) It is the least discussed concept of Abdellahs typology.

2) It include the atmosphere of a client room, home and
community

Abdullah also discuss a therapeutic environment but does not define it
C) Health:

1)It is not specifically defined by Abdellah, but she refers to health and a
healthy state of mind body, the clients continued health is the purpose of
nursing

2) It is viewed as a state that excludes illness

3)It can also described as a state in which the person has no unmet needs
and no anticipated actual impairment
d) Nursing:

1)It is a helping profession

2) It is a comprehensive service that combines art and science

3) Does something to (or) for a client (or) provides information that helps
meet the client needs, increases or restores self help ability or alleviates
as impairment

4) Uses the nursing process, a problem-solving approach

5)Can use the 21 nursing problems as a guide for nursing care

* Limitations :

- Very strong Nursing centered orientation
- with this orientation appropriate uses might be the organizations of
teaching content for nursing students, the evaluation of a students
performance in the clinical area (or) both but in terms of clients care,
there is little emphasis on what the client is to achieve

- Abdellahs frame work is inconsistent with the concept of holism.

.



* Conclusion

Abdellas theory and frame work provide basis for determining and
organizing nursing care. if all of the problem are investigated, the client
would be likely to be thoroughly assessed.