Fundamentals of Nursing I

Introduction:

From Topic 2 to Topic 4 will introduces the nursing theorist as nursing theory is essential concept used in nursing education, research and clinical setting.

 

Topic Learning Outcome (TLOs):

By the end of this topic, you should be able to:

1. Discuss selected nursing theories clearly

·         Roy’s Adaptation Model

·         King’s Goal Attainment Theory

Roy’s Adaptation Model

•      Sister Callista Roy defines ADAPTATION as the “process and outcome whereby the thinking and feeling person uses conscious awareness”. She creates human and environmental are integration. The theory focuses on increasing complexity of person and environment; Self-organization; Relationship between and among persons. This theory also focuses on the individual as biopsychosocial adaptive system. Roy believe that creation spirituality- view that “persons and the earth are one and that they are in God and of God” and Universe and supreme being.

•      Theory employs feedback cycle of the input (stimuli); Throughout (control processes) and Output (behavioral and adaptive response). Both individual and environment are sources of stimuli requiring modification to promote adaptation and ongoing purposive response. Process she defined as being and becoming integrated is the adaptive responses contribute to health; Ineffective and maladaptive responses do not contribute to health and each person’s adaptation is unique and constantly changing.

•      Individual respond to needs (stimuli) are in four modes:

1.      Physiologic mode involves the body’s basic physiologic needs and ways of adapting with regards to fluid and electrolytes, activity, rest, circulation, oxygen, nutrition, elimination, protection, senses neurologic and endocrine function. Behaviour pertaining to the physical aspect of the human system; Physical and chemical processes.

2.      Self-concept have 2 components, which are physical self-involving sensation and body image and personal self (self-ideal) self-consistency and the moral –ethical self. The composite of beliefs and feelings held about oneself at a given time. It focusses on the psychological and spiritual aspects of the human system.

3.      Role of function determined by the need for social integrity and performance of duties based on the given position in the society

4.      Interdependence mode is ones relation with significant others and support system that provide help, affection and attention.

•      The goal of Callista’s Roy model is enhancing life processes through adaptation in four adaptive modes. Behaviour pertaining to interdependent relationships of individuals and group where each relationship exists for some reason.

King’s Goal Attainment Theory

 

•      King’s conceptual framework for nursing consist of three dynamic interacting system: Relationship of operational systems (individual’s); interpersonal system (groups) and social system (educational or health care system). The theory selected 15 concepts from nursing, which are Self-role; Perception; Communication; Interaction; Transaction; Growth and development; Stress; Time; Personal space; Organization; Status; Power; Authority; Decision making and Essential knowledge for use by nurses.

•      In the transaction model design, it describes the nature of and standard of nurse-patient interaction (goal-attainment) where nurse purposely interact and mutually set, explore and agree to means to achieve goals. So, goal-attainment represent outcomes. For examples, recorded information in the patient record, represent evidence-based practice; Provides insights into nurse’s interaction with the individual or groups. It highlights the importance of client’s participation in decisions that influence care and focuses on nurse-client interaction and outcomes of care.