nursing theories 2
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Roy's Adaptation Model
Sr.Callista Roy
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THEORY DESCRIPTION
The central questions of Roys theory are:
Who is the focus of nursing care?
What is the target of nursing care?
When is nursing care indicated?
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ROY ADAPTATION MODEL CONCEPTS
Adaptation -- goal of nursing
Person -- adaptive system
Environment -- stimuli
Health -- outcome of adaptation
Nursing -- promoting adaptation and health
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Concepts-Adaptation
Responding positively to environmental
changes.
The process and outcome of individuals andgroups who use conscious awareness, self
reflection and choice to create human and
environmental integration
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Concepts-Person Bio-psycho-social being in constant interaction with a
changing environment
Uses innate and acquired mechanisms to adapt
An adaptive system described as a whole comprised ofparts
Functions as a unity for some purpose Includes people as individuals or in groups-families, organizations, communities, and society as
a whole.
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Concepts-Environment
Focal - internal or external and immediately
confronting the person
Contextual- all stimuli present in the situationthat contribute to effect of focal stimulus
Residual-a factor whose effects in the current
situation are unclear
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Concepts-Health
Inevitable dimension of person's life
Represented by a health-illness continuum A state and a process of being and
becoming integrated and whole
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Concepts-Nursing To promote adaptation for individuals and groups in the four
adaptive modes, thus contributing to health, quality of life, and
dying with dignity by assessing behaviors and factors that
influence adaptive abilities and by intervening to enhance
environmental interactions
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Concepts-Subsystems
Cognator subsystem A major coping process involving 4
cognitive-emotive channels(perceptual and information
processing, learning, judgment, and emotion)
Regulator subsystem a basic type of adaptive process that
responds automatically through neural, chemical, and endocrine
coping channels
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Four Adaptive Modes
Physiologic Needs
Self Concept Role Function
Interdependence
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Adaptation and Groups
Includes relating persons, partners,
families, organizations,communities, nations, and society
as a whole
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Adaptation LevelA zone within which stimulation will lead to a
positive or adaptive response
Three levels
1. Integrated
2. Compensatory
3. Compromised
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Integrated Life Processes
Adaptation level where the structures and functions
of the life processes work to meet needs
Stable process of breathing and ventilation
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Compensatory Processes
Adaptation level where the cognator and regulator
are activated by a challenge to the life processes
Role transition, growth in a new role
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Compromised Processes
Adaptation level resulting from
inadequate integrated and
compensatory life processes
HypoxiaUnresolved Loss
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Usefulness of Adaptation Model
Scientific knowledge for practice
Clinical assessment and intervention
Research variables
To guide nursing practice
To organize nursing education Curricular frame work for various nursing
colleges
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Jean Watson's Philosophy ofNursing
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The seven assumptions1. Caring can be effectively demonstrated and
practiced only interpersonally.
2. Caring consists of carative factors that result in
the satisfaction of certain human needs.
3. Effective caring promotes health and individual or
family growth.
4. Caring responses accept person not only as he or
she is now but as what he or she may become.
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The seven assumptions
5.Caring is more healthogenic than is curing. A
science of caring is complementary to the
science of curing.
6. The practice of caring is central to nursing.
7. A caring environment is one that offers the
development of potential while allowing the
person to choose the best action for himself or
herself at a given point in time.
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The ten primary carative factors
1. The formation of a humanistic- altruistic system of values.2. The installation of faith-hope.
3. The cultivation of sensitivity to ones self and to others.4. The development of a helping-trust relationship
5. The promotion and acceptance of the expression of positive and
negative feelings.
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The ten primary carative factors
6. The systematic use of the scientific problem-solving method for decision making
7. The promotion of interpersonal teaching-learning.
8. The provision for a supportive, protective and /or corrective mental, physical,
socio-cultural and spiritual environment.
9. Assistance with the gratification of human needs.
10. The allowance for existential-phenomenological forces.
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Watsons ordering of needs
* Lower order needs (biophysical needs)
o The need for food and fluid
o The need for elimination
o The need for ventilation
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* Lower order needs (psychophysical needs)
o The need for activity-inactivity
o The need for sexuality
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* Higher order needs (psychosocial needs)
o The need for achievement
o The need for affiliation
o Higher order need (intrapersonal-
interpersonal need)
o The need for self-actualization
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Watsons theory and the four
major concepts
Human being refers to
.. a valued person in and of him or herself tobe cared for, respected, nurtured, understood
and assisted; in general a philosophical view of a
person as a fully functional integrated self. He,human is viewed as greater than and different
from, the sum of his or her parts.
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Health
A high level of overall physical, mental and
social functioning
A general adaptive-maintenance level of dailyfunctioning
The absence of illness (or the presence of efforts
that leads its absence)
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Environment/society
* Caring (and nursing) has existed in every
society.
* A caring attitude is not transmitted fromgeneration to generation.
* It is transmitted by the culture of the profession
as a unique way of coping with its environment.
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Nursing
* Nursing is concerned with
promoting health, preventingillness, caring for the sick and
restoring health.
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Nursing
It focuses on health promotion and
treatment of disease. She believes that
holistic health care is central to the
practice of caring in nursing
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Nursing
She defines nursing as:
a human science of persons and human
health-illness experiences that are
mediated by professional, personal,
scientific, esthetic and ethical human
transactions.
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From Novice to Expert
Patricia E. Benner
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LEVELS OF NURSING EXPERIENCE
1. Novice
2. Advanced beginner
3. Competent
4. Proficient5. Expert
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Novice
Beginner with no experience
Taught general rules to help perform tasks
Rules are: context-free, independent of specific
cases, and applied universally
Rule-governed behavior is limited and inflexible
Ex. Tell me what I need to do and Ill do it.
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Advanced Beginner
Demonstrates acceptable performance
Has gained prior experience in actual situations
to recognize recurring meaningful components
Principles, based on experiences, begin to be
formulated to guide actions
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Competent Demonstrates acceptable performance
Has gained prior experience in actual situations to
recognize recurring meaningful components
Principles, based on experiences, begin to beformulated to guide actions
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Competent
Gains perspective from planning own actions
based on conscious, abstract, and analytical
thinking and helps to achieve greater efficiencyand organization
typically a nurse with 2-3 years experience on the job inthe same area or in similar day-to-day situations
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Proficient
Perceives and understands situations as whole
parts
More holistic understanding improves decision-making
Learns from experiences what to expect in
certain situations and how to modify plans
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Expert No longer relies on principles, rules, or
guidelines to connect situations and determine
actions
Much more background of experience
Has intuitive grasp of clinical situations
Performance is now fluid, flexible, and highly-
proficient
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