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

·         Peplau’s Interpersonal Relations Model

·         Orlando’s Nursing Process

·         Leininger’s Cultural Care Diversity

Peplau’s Interpersonal Relations Model

Hildergard Peplau is a psychiatric nurse. Introduced her interpersonal concepts in 1952. She emphasizes on use of therapeutic relationship between the nurse and the client. Nurse-Patient Relationship consists of four phases the following it sequences:

Ø  Orientation phase is client seeks help

Ø  Identification phase is assuring the person the nurses understanding of the situation

Ø  Exploitation phase is deriving full value from the relationship

Ø  Resolution phase is older goals are put aside, newer new ones are adopted

This model is essential for nurses because nurse assumes many roles, such as Stranger, Teacher, Resource person, Surrogate, Leader and Counselor.

Orlando’s Nursing Process Theory

•      Orlando developed nursing process theory in the late 1950's as she observed nurses in action. She saw "good" nursing and "bad" nursing. From her observations she learned that the patient must be the central character and nursing care needs to be directed at improving outcomes for the patient, and not about nursing goals.  Therefore, the nursing process is an essential part of the nursing care plan. There are four steps in nursing process:

•      Assessment is deliberative nursing process used to share and validate the nurse’s direct and indirect observation.

•      Planning occurs with participation from the nurse and the patient.

•      Both direct help and indirect help occur in the implementation phase.

•      Evaluation is focus on change in the patient’s behaviour. If no change, nurse continues the process until improvement occur. 

Leininger’s Cultural Care Diversity

•      Madeleine Leininger is a well-known anthropologist. She develops transcultural nursing in 1970s. In 1991 published her book Culture Care Diversity and Universality: A theory in Nursing. Leininger consider care is essence of nursing and the dominant, distinctive and unifying feature of nursing. She emphasizes on human caring.

Leininger produced the sunrise model to depict her theory of cultural care diversity and universality. The model emphasize health is influenced by elements of social structure, such as Technology; Religious; Philosophical; Kinship and social system; Cultural values; Political and legal factors; Economic factors and Educational factors. Each of the system is part of the social structure of any society in health care expression, patterns and practices. Leininger’s three importance intervention modes are: 

Ø  Culture care and preservation

Ø  Culture care accommodation, negotiation or both

Ø  Culture care restructuring and repatterning