NCM 103 LEC Fundamentals of Nursing LESSON: CONCEPTS OF NURSING Lecturer: Ma’am Regie Jimenez - - - Nursing Is a caring It is practiced with an earnest concern for the art of care & the science of health. Involves a humanistic blend of scientific knowledge & holistic nursing practice. Is an art Is a science Client centered Is holistic Is adaptive Is a helping profession. Concerned with health promotion, health maintenance, and health restoration. Concepts of Nursing The four major concepts in nursing theories: -Person -Environment -Health -Nursing rehabilitating the sick & disabled. (Rogers) - A theoretical system of knowledge that prescribes a process of analysis & action related to the care of the ill person. (Roy) - A helping or assisting service to persons who are wholly or partly dependent-infants, children & adults- when they, their parents & guardians or other adults responsible for their care are no longer able to give or supervise their care. (Orem) - A helping profession that assists individuals & groups in society to attain, maintain & restore health. If this is not possible, nurses help individuals due with dignity. (King) - A unique profession in that it is concerned with all of the variables affecting an individual’s response to stressors, which are intra, inter & extra personal in nature. (Neuman) - An external regulatory force that acts to preserve the organization & integration of the client’s behavior at an optimal level under those conditions in which the behavior constitute a treat to physical or social health or in which illness is found. (Johnson) - It also encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. (ICN) -The act of utilizing the environment of the patient to assist him in his recovery (Nightingale) - - The unique function of the nurse is to assist the individuals, sick or well, in the performance of those activities contributing to the health or its recovery (or to peaceful death) the he would perform unaided if he had necessary strength, will or knowledge, & to do this in such a way as to help him gain independence as rapidly as possible…. (Henderson’ adopted by ICN in 1960) A humanistic science dedicated to compassionate concern with maintaining & promoting health preventing illness & caring for & NCM 103 LEC Fundamentals of Nursing LESSON: CONCEPTS OF NURSING Lecturer: Ma’am Regie Jimenez Characteristics of Patients Concern to Nurses 1. Resiliency - the capacity to return to a restorative level of functioning using compensatory/coping mechanisms; the ability to bounce back quickly after an insult. 2. Vulnerability - susceptibility to actual or potential stressors that may adversely affect patient outcomes. 3. Stability - the ability to maintain a steady-state equilibrium. 4. Complexity - the intricate entanglement of two or more systems (e.g., body, family, therapies). 5. Resource availability - extent of resources (e.g., technical, fiscal, personal, psychological, and social) the patient/family/community bring to the situation. 6. Participation in care - extent to which patient/family engages in aspects of care. 7. Participation in decision-making extent to which patient/family engages in decision-making. 8. Predictability - a characteristic that allows one to expect a certain course of events or course of illness. Nurse Competencies of Concern to Patients 1. Clinical Judgment 2. Advocacy and Moral Agency 3. Caring Practices 4. Collaboration 5. Systems Thinking 6. Response to Diversity 7. Facilitation of Learning 8. Clinical Inquiry (Innovator/Evaluator) The Roles & Functions of a Professional Nurse CONCEPT OF HEALTH AND ILLNESS ▪ Health is the process through which a person seeks to maintain an equilibrium that promotes stability and comfort. ▪ Health - (traditional) absence of illness - (WHO) state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. - (Leavell & Clark) balance between (disease) agent and host in a given NCM 103 LEC Fundamentals of Nursing LESSON: CONCEPTS OF NURSING Lecturer: Ma’am Regie Jimenez environment. - Expression of physical vigor, of freedom from discomfort. ▪ Health refers to all aspects of a person’s life. ▪ Physical status ▪ Emotional well-being ▪ Social relationships WELLNESS PERSPECTIVES ▪ Intellectual functioning ▪ Spiritual condition ▪ Wellness places health on a continuum, from one’s optimal level (wellness), to a maladaptive state (illness). - is the condition in which an individual functions at optimal levels ▪ High-level wellness means functioning to one’s maximum health potential while remaining in balance with the environment. CONCEPT OF HEALTH AND ILLNESS ▪ Illness is the inability of an individual’s adaptive responses to maintain physical and emotional balance, which results in an impairment of functional abilities. - the manifestation of “human physical, emotional, spiritual and mental discomforts”. ILLNESS PERSPECTIVES ▪ Illness is the result of a disease or injury that affects functioning and occurs when there is an inability to meet one’s needs. ▪ An acute illness is usually characterized by a rapid onset, intense manifestations, and a relatively short duration. ▪ A chronic illness is usually characterized by a gradual, insidious onset with lifelong changes, usually irreversible. CONCEPT OF HEALTH AND ILLNESS ▪ Disease – is a state in which one or more component or conditions of the cell fluids are out of equilibrium: temperature, water, salts, nutrients, gases or hormones. - Fluid around the cells may also be disturbed by foreign substances, bacteria, their toxins, other persons or mechanical obstacles that prevent free circulation of this fluid. - Emotions can produce a disequilibrium in hormone, nutrients, salts, gases and water just as completely as can toxic substances that are swallowed or growth that interfere mechanically with the circulation. (Claude Bernard). ▪ Homeostasis – the ability of living things to maintain constancy of their internal milieu despite changes in the environment. - an equilibrium among psychological, physiological, sociocultural, intellectual and spiritual needs. - Maintenance of health in harmony and balance among body, mind and spirit ▪ Adaptation – the process by which a person adjust to achieve homeostasis. Note: Concept of health and illness – the theory of humoral qualities; hot (init) and cold (lamig)….equilibrium between these two brings about health, disequilibrium and illness. NCM 103 LEC Fundamentals of Nursing LESSON: CONCEPTS OF NURSING Lecturer: Ma’am Regie Jimenez HEALTH – ILLNESS CONTINUUM MODELS OF HEALTH ▪ Health is the maintenance of harmony and balance among body, mind, and spirit. ▪ Balance or homeostasis is an equilibrium among psychological, physiological, sociocultural, intellectual, and spiritual needs. THREE AREAS THAT DESCRIBES PEOPLE HEALTH STATUS: THREE AREAS THAT DESCRIBES PEOPLE HEALTH STATUS: ▪ Presence or absence of symptoms (physical & emotional) ▪ How they feel (emotionally & physically) ▪ What they are able to do ( ability to function Note: Health can be studied both in individuals and in groups (families and communities) INFLUENCES ON HEALTH STATUS ▪ belief & attitudes ▪ cultural factors ▪ environmental factors ▪ lifestyle behaviours ▪ political systems ▪ socioeconomic status ▪ religious factors ▪ family factors CULTURAL INFLUENCE ON HEALTH ▪ Culture affects how an individual views health and illness. ▪ One’s cultural background influences health-related behaviors and expectations of treatment when illness occurs. FAMILY INFLUENCES ON HEALTH CARE ▪ Families help determine the following: ▪ Whether or not to seek treatment. ▪ What type of treatment is appropriate. ▪ Who should provide the treatment or care. ▪ Where the treatment or care should be provided. ▪ Families are often the major caregivers for their relatives. ▪ Extended families and communities have traditionally acted as a buffer against excessive stress and illness. ▪ Lack of social support from family or significant others results in psychological and spiritual isolation, which may negatively impact a person’s physiological state. HEALTH BEHAVIORS AND VARIABLES INFLUENCING HEALTH ▪ Behavior is defined as the observable response of an individual to external stimuli. ▪ All behavior has meaning. ▪ Variables Influencing Health ▪ Lifestyle ▪ Locus of Control ▪ Self-Efficacy ▪ Health Care Attitudes ▪ Self-Concept ▪ Cognition ▪ Variables Influencing Health NCM 103 LEC Fundamentals of Nursing LESSON: CONCEPTS OF NURSING Lecturer: Ma’am Regie Jimenez ▪ ▪ ▪ Age and Developmental Levels Gender Previous Experiences with the Health Care System Environment Economic Resources HEALTH CARE ▪ ▪ TYPES OF SERVICES ▪ Primary: Health Promotion & Illness Prevention Examples: Teaching, lifestyle modification for health (smoking cessation, nutritional counseling), referrals, immunization, promotion of safe environment ( sanitation, protection from toxic agents). ▪ Secondary: Diagnosis & Treatment Examples: Screening, early diagnosis, acute care, surgery ▪ 3. Tertiary: Rehabilitation Examples: Education and retraining, provision of direct care, environmental modification advising a necessity of wheelchair accessibility for CVA pt. TYPES OF NURSING INTERVENTION ▪ Independent or nurse initiated intervention ▪ Dependent or physician initiated intervention ▪ Interdependent or collaborative intervention LEVEL OF CARE ▪ Health Promotion ▪ Health Maintenance ▪ Rehabilitation ▪ Disease Prevention HEALTH PROMOTION AND DISEASE PREVENTION (HEALTH PROTECTION) ▪ Disease Prevention ▪ Activities/behaviors that protect people from the ill effects of actual or potential health threats ▪ Primary prevention ▪ Secondary prevention ▪ Tertiary prevention HEALTH PROMOTION ON A GLOBAL LEVEL ▪ World Health Organization ▪ Organizes international conferences and meetings and disseminates successful health promotion strategies, programs, and policies. HEALTH PROMOTION ▪ Healthy People Initiative ▪ Promote healthy behaviors. ▪ Promote healthy and safe communities. ▪ Improve systems for personal and public health. ▪ Prevent and reduce diseases and disorders. IMPLEMENTATION ▪ Health Promotion and Vulnerable Populations ▪ Children ▪ The Elderly ▪ Economically Disadvantaged ▪ Homeless ▪ The Individual as a Holistic Being ▪ The client with health maintenance considerations is a holistic being. ▪ Individuals function as complete units that cannot be reduced to the sum of their parts. ▪ Needs and Health NCM 103 LEC Fundamentals of Nursing LESSON: CONCEPTS OF NURSING Lecturer: Ma’am Regie Jimenez ▪ The entire person (mind, body, and spirit) is influenced by satisfaction of needs. ▪ Basic human needs are those that are necessary for every person’s survival. HEALTH MAINTENANCE ▪ The client manages his health ▪ Behavior directed toward maintaining a current level of health ▪ Health maintenance activities are the activities/behaviors an individual performs to maintain or improve a current level of health. ▪ Risk Factor Identification in Health Maintenance ▪ Physical, environmental, psychological behaviors that increase the vulnerability of an individual to disease or injury ▪ Laboratory and Diagnostic Tests and Health Maintenance ▪ Laboratory data includes cholesterol levels, blood glucose, urine studies. ▪ Health maintenance behaviors may be measured with varieties of diagnostic tests and equipment. ▪ Client education about what to do with results obtained from these tests is given. CHARACTERISTICS OF HEALTH MAINTENANCE ▪ Perception ▪ Motivation ▪ Maintenance REHABILITATION ▪ Focus is on quality of life. ▪ ▪ ▪ ▪ Return the client to normal functional ability. ▪ Adapt activities and lifestyle to resume family and work roles. To prepare a disabled or disadvantaged person for employment by vocational counseling or training Functional Ability ▪ Physical, cognitive, and emotional skills required to perform activities of daily living Rehabilitate (two components) ▪ To restore to a normal or optimal state of health, and ▪ constructive activity by medical, physical, and psychological therapy ROLES OF NURSES IN REHABILITATION ▪ Educator ▪ Caregiver ▪ Coordinator ▪ Client Advocate ▪ Researcher ▪ Life Care Planner CLASSIFICATION OF TERMS ▪ Disability ▪ Impairment ▪ Handicap NURSING THEORY AND RESTORATION CARE - Orem’s Self-Care Model (1959) ▪ Self-esteem ▪ Independence ▪ Overcoming deficits THREE LEVELS OF PREVENTION NCM 103 LEC Fundamentals of Nursing LESSON: CONCEPTS OF NURSING Lecturer: Ma’am Regie Jimenez ▪ BASIC INTERVENTION: MASLOW’S HIERARCHY OF NEEDS NEEDS AND HEALTH ▪ Physiological Dimension ▪ Focuses on achievement of the basic needs of a client. ▪ The nurse must assess for system alterations and then provide interventions to meet these needs. PHYSIOLOGICAL DIMENSION OF NEEDS AND HEALTH ▪ Physical Self-Examination Techniques ▪ Health Maintenance in NutritionManagement Behaviors ▪ Health Maintenance and Alterations in Sleep Patterns ▪ Treating the client as a unique individual. ▪ Protecting confidentiality. Using touch and personal space in a therapeutic manner. ▪ Recognizing and respecting cultural differences. ▪ Decreasing anxiety through stress management techniques. SOCIOCULTURAL DIMENSION OF NEEDS AND HEALTH ▪ Empowerment is a process of enabling others to do for themselves. ▪ Nurses empower clients by teaching them and their families how to develop skills for selfcare and for healthier living. INTELLECTUAL DIMENSION OF NEEDS AND HEALTH ▪ Cognitive function and development can be impaired by multiple factors. • Infection • Exposure to toxins • Substance abuse • Trauma • Psychological problems SPIRITUAL DIMENSION OF NEEDS AND HEALTH ▪ Spirituality assists a person in determining the sense of meaning or purpose in one’s life. ▪ Spirituality is multidimensional. • A sense of oneself • A sense of connection with others • A relationship with a higher power or divine source SEXUAL DIMENSION OF NEEDS AND HEALTH ▪ Sexuality refers to all aspects of being male or female, including feelings, attitudes, beliefs, and behavior. ▪ Sex roles are culturally determined patterns associated with being male and female. NCM 103 LEC Fundamentals of Nursing LESSON: CONCEPTS OF NURSING Lecturer: Ma’am Regie Jimenez
