10.간호의 관심 사람(4)
TRANSCRIPT
Introduction to Nursing
Kasil Oh, PhD, RN
간호학입문
간호의 관심 Domains of Nursing
• 사람 (person)
• 환경 (environment)
• 건강 (health)
• 간호 (nursing)
간호학입문
간호의 대상
Person 사람
개인 (person)
가족 (Family)
집단 (group)
조직 (organization)
지역사회 (community)
Nursing’s metaparadigmPerson(1)
1. The person as an Open System. The interrelationships also contribute to making the whole greater than the sum of its parts. This interrelation further increases the complexity of each of us as unique individuals. Figure is a typi-cal representation of the holistic person. Note the following three reflected in the figure : 1. The subsystems represent interacting wholes that are greater than the sum of the parts.2. The broken lines between the subsystems indi-cate the passage of energy among the subsys-tems.3. Inherent throughout the whole are the genetic base and spiritual drive that make all persons unique.
Key Concepts in General Sys-tems Theory
• A System is a interrelated parts.• The parts form a meaningful whole.• The whole is different from and grater than the
sum of its parts.• Systems may be open of closed.• Systems strive for homeostasis(internal stability)• Change in one part of the system creates change
in other parts.
Figure 10-2 General systems model.
Open system 개방된 체계
간호학입문
Variables of Person
• Biological• Psychological, • Sociological, • Spiritual
• Developmental, “BEING”
간호학입문
간호학입문
TABLE 4-1 Selected Variables of the Person
Biologic Psychological Sociological SpitirualAge Attitudes Basic needs Beliefs
Genetic structure Basic needs Culture Philosophy of life Sex Body image Family ReligionRace Communication Group membership ValuesBiologic rhythms Coping mechanisms LanguageBasic needs Defense mechanisms Life-style
Growth Feeling statesRelationship withothers
Acid-base balanceLevel ofdevelopmentalresolution
Roles
Circulation Perception Role prescriptionsDigestion Self-concept School systemsElectrolyte balance ValuesImmune response CognitionMobility ConsciousnessReproduction KnowledgeRespiration MemoryTemperatureregulation
Thoght process
Physical healthPast illness
간호학입문
2. Holism: 전인
• 어원 : Holistic & Holism (Greek): Whole• 사람의 부분은 상호 관계하며 전체를 위하여 기여한다 .• 부분은 상호 의존하며 체계적인 방법으로 조화를 이룬다 .• 전체는 부분의 합보다 더 크다 .• 부분 :
1. biophysical 신체 , 2. psychological 정신 ,3. social 사회 , 4. cognitive 인지
Nursing’s metaparadigmPerson(2)
• Holistic personThe words holistic and holism are derived from the Greek word meaning whole. Holism is basically a theory in which the universe, and especially living nature, is seen in terms of in-teracting wholes that are more than the sum of their parts. Smuts(1926) indicated that holism is a theory that describes the parts of person as dependent on each other and coordinated in a systematic fashion. According to this theory, studying one part of a per-son indicates the need to consider how that part in-terrelates with all other parts of the person. An ap-preciation for the parts as whole suggests the pur-pose and function of each individual part.
간호학입문
3. Basic Needs 사람은 기본 욕구 를 가지고 있다 .
– Activity & Rest 활동과 휴식– Security & Safety 안전과 안정 , – Oxygen 산소 , – Nutrition & elimination 영양과 배설 , – Sexuality 성 욕구
간호학입문
3. 사람은 자아 실현을 하기 위해 산다 .Self-actualizing person
Maslow 의 욕구단계 + 영적 욕구 =자유 Freedoms– to speak, does not harm others, ex-
press oneself, – to seek justice,– to find fairness, honesty orderliness
in the group
Nursing’s metaparadigPerson(3)
Self-actualizing person A human need is something that is a requirement for the person’s well-being. Theory of human motivation by Maslow(1954) de-scribed the relationship of motivation and needs. He suggested that human behavior is motivated by needs. He iden-tified five levels of needs and organized them into a hierarchical order, as shown the following picture.
Maslow’s Hierarchy of needs
Priority of Human Needs
간호학입문
4. Developing throughout life long: Growing person 사람은 태어나서부터 발달한다 .
– Physical 신체발달– Social 사회발달 -Erickson
– Mental 인지발달 -Piaget
– Spiritual 영적 발달
간호학입문
Theoretical perspectivesof human growth and develop-
ment
1. psychoanalytic2. learning3. cognitive4. contextual5. evolutional/sociological
간호학입문
Development Tasks – Erikson -
61years and on, late adult-hood
41-60years
20-40years
12-20years
6-11years
4-5years
1-3years
Birth-1year Basic trust versus mistrust
Autonomy versus
Shame and doubt
Initiative versus guilt
Industry versusinferiority
Identity versusRole confusion
Intimacy versusisolation
Generativity versusstagnation
Ego integrity versusdespair
Cognitive development인지발달 -Piaget
1. Sensorimotor Level: Birth to 2 Years
감각운동기 ( 출생 -2 세 ): 모방 , 기억 , 사고의 시작 . 단순 반사적 행동에거 목적성 행동으로 발전– 반사운동 ( 출생 -1 개월 )– 일차순환 반응 (1-4 개원 )– 이차순환 반응 (4-8 개월 )– 이차순환 반응의 협응 (8-12 개월 )– 삼차 순환 반응 (12-18 개월 )– 사고의 시작 (18-24 개월 )
2. Preoperational Level: Age 2 to 7 Years
전조작기 (2-7 세 ): 일반적 관점에서 사고기능
자기중심적 , – 전 개념적 사고 (2-4 세 )– 직관적 사고 (5-7 세 )
Cognitive Development: Piaget
3. Concrete operational stage (7-11 세 ) 구체적 조작기 : 보존개념 , 유목화 , 서열화 , 가역성개념습득
4 . Formal Operations Level: Age 11 to 16 Years
형식적 조작기 (11-16 세 ): 과학적 사고 가능 , 복잡한 언어과제 , 가설적 문제해결
Structural hierarchy of nurs-ing knowledge components• Metaparadigm: person, environment, nurs-
ing, health
• Philosophies: Nightingale, Watson, Benner
• Conceptual models: King, Newman, Orem, Rogers, Roy
• Grand theory: • Middlle-range theory
간호이론가들의 인간관- 조사하여 정리해 둡시다 .-
A. Theories Based on Basic needs 욕구이론B. Theories Based on Interactive process 상호작용이론C. Theories Based on Unitary process 총체 , 전인이론
F. Abldellah(1960)
Patient: 간호가 필요한 개인 , 건강관리 제공자가 결정
사람들의 건강욕구와 관련된 중요한 간호문제를 해결하기
위해 문제해결방법을 활용하는것
Virginia Henderson (1966)
Henderson
• Patient: 간호가 필요한 사람 , not limit nursing to illness
D. Orem(1979)
Orem 1971
• Humans: 남 , 여 , 어린이• Person as agent(1995)
D. Johnson 1974
• Human: behavioral system that strives to make continual adjustment to achiev e, maintain or regain bal-ance to the steady-state that is adap-tation(1980)
Betty Neuman
Betty Neuman 1995
• Human beings: client/client system• Composite of variables: physiologi-
cal, psychological, sociocultural, de-velopment and spiritual
• Each of which is subpart of all parts…forms the whole of the client
B. Interactive process
• 상호작용과정에 기본을 둔 이론
Imogine King (1981)
Imogine King (1981)
• Individual: social beings who are ra-tional and sentient
• Communicate thought, actions, cus-toms, and beliefs through language.
Dynamic interacting systems
SOCIAL SYSTEM ( COMMU-NITY )
INTERPERSONAL SYSTEM ( GROUP )
PERSONAL SYSTEM ( INDIVIDUALS )
F. Nightingale (1859)
Sister Callista Roy
C. Roy
• “the human adaptive system as a whole with parts that function as a unity for some purpose
• Human systems include people, group, or-ganizations, communities, and society as a whole
• “Individual adapt to coping with stimuli form the environment
• Adaptation is a dynamic process• Adaptation is the positive response to the
stimuli
Based on Unitary process
M. Rogers (1970)
M. Rogers (1970)
• unitary human beings: irreducialbe , indi-visible, multidimensional energy fields identifies by pattern and manifesting characteristics that are specific to the whole and which cannot be predicted from the knowledge of the parts
• Energy fields ate open, dynamic, unique.
인 간 장 환 경 장
상 호 작 용
간 호 중 재
Potential Changes
(State of Living) (State of Environment)
(Pattern of Health-Illness Continuum )
Rosemarie Rizzo Parse
Parse 1998
• Intentional beings involved with their world, having a fundamental nature of knowing, being present, and open to their world
• The unitary human is one who copar-ticipates in the universe in creating becoming and who is whole, open, and free to choose ways of becoming
< 함께 있으면 좋은 사람 > - 용혜원 -
그대를 만나던 날 느낌이 참 좋았습니다착한 눈빛 , 해맑은 웃음 , 한마디 한 마디 말에도 따뜻한 배려가
있어잠시 동안 함께 있었는데 오래 사귄 친구처럼 마음이 편안했습니다 .
내가 하는 말들을 웃는 얼굴로 잘 들어주고어떤 격식이나 체면차림 없이 있는 그대로를 보여주는솔직하고 담백함이 참으로 좋았습니다 .
짧은 만남이지만 기쁘고 즐거웠습니다 .오랜만에 마음을 함께 맞추고 싶은 사람을 만났습니다 .
그대는 함께 있으면 있을수록 더 좋은 사람입니다
