Basic concepts
in nursing science
Li Xiaohan
School of Nursing
China Medical University
March, 2005
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Introduction
1. Definition of nursing science
2. Four basic concepts that affect and determine the nursing practice
(1) Human being
(2) Environment
(3) Health
(4) Nursing
Human being
1. The human being is a uniform whole （entirety）
(1) Concept of a whole
(2) The uniform whole of human being
1) Physiological
2) Psychological
3) Social
4) Spiritual
5) Cultural
3. The human being is an open system (open whole)
(1) Close system
(2) Open system
4. The scope of human being in nursing
(1) Individual
(2) Family
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(3) Community
(4) Society
Basic goal of human being: To maintain the balance of organism
(1)
Balance among subsystems of an organism
(2)
Balance between organism and its environment
(internal environment and external environment)
2. Basic need of human being
(1) Definition of basic need
1) Need
2) Basic need of human being
(2) Types of basic need
1) Physiological need
2) Social need
3) Affective need
4) Cognitive need
5) Spiritual need
(3) Characteristics of basic need
1) Approximately same basic need
2) The importance of each need for each person is different
3) All the basic needs are interconnected and interactive
(4) Factors that affect meeting needs
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1) Physiological elements
2) Emotional elements
3) Knowledge and intellectual elements
4) Social elements
5) Environmental elements
6) Individual elements
7) Cultural elements
(5) The theory related to basic needs
—Maslow’s hierarchy theory of Basic needs for Human Being
1) Theory’s basic content
a) Physiological needs
b) Safety needs
c) Love and belongingness needs
d) Self-esteem needs
e) Needs for self-actualization
2) Basis for need’s hierarchy
a) Importance of needs
b) Sequence of need’s appearance
3) General rules
4) Significance to nursing
a) To identify client’s unmet needs
b) To realize and understand client’s words and behaviors
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c) To predict client’s unspoken needs
d) To collect client’s data comprehensively in case of missing
e) To put client’s nursing problems in adequate order
3. Growth and development of human being
(1) Definition of growth and development
1) Growth：a increase on amount in physiological aspect.
a) height
b) weight
c) age
2) Development:
(a)Definition:
a
changing
process
in
physical
and
psychological aspect along with age’s increase and interaction
between individual and its environment.
(b) Characteristics of development:
a) in order
b) predicted
c) persistent
d) as a result of learning and a symbol of maturation
e) holistic (physiological, psychological, social )
3) Maturation:
(a) narrow definition: the process of the growth in physiological
aspect and the potential in developmental aspect were exerted fully
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(b) generalized definition: a individual has not only obtained full
development in physiological aspect, but also put up many mature
behaviors.
(2) Content of growth and development
1) Physiological
2) Cognitive
3) Social
4) Affective
5) Spiritual
6) Moral
(3) Basic principle of growth and development
1) Persistent, in sequence, regular, predicted .
2) Common development process
3) Passing each developmental stage in unique manner and
speed.
4) Character and definite developmental tasks in each
developmental stage
5) Development in infant phase will affect the following basic
attitude, temperament, life style and behaviors.
6) Development is obtained by gradual maturation and constant
learning.
(4) Factors that affect growth and development
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1) Heredity
2) Environment
(a) Family
(b) School
(c) Other: religion, culture, society, learning, and life
experiences
4. Self-concept of human being
(1) Definition of self-concept: a person’s attitude towards to
himself (herself )
(2) Generation of self-concept: the combination of other’s opinion
to a person and a person’s self-detection and self-cognition.
(3) Components of self-concept
1) Body image (appearance, physical
structure, physical
function)
2) Role performance
3) Personal identity
4) Self-esteem
(4) Importance of a well self-concept
1) Affecting one’s thoughts and behaviors
2) Affecting one’s choices
3) Affecting other’s attitude to oneself
4) Affecting one’s ability of meeting an emergency when one is in
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the face of (affronts)various changes.
Environment
1. Definition of environment
(1) Roy’s definition of environment: the summation of all factors
that surround and affect the behaviors and development of
individual or collectivity.
(2) Henderson’s definition of environment: a general name of all
external factors that affect the life and development of organism.
2. Classification of environment
(1) Internal environment: the environment in the organism
(2) External environment
1) Natural environment (entironment)
(a) Physical environment: air, water, sunlight, soil
(b) Biological environment: animal, plant, microorganism
2) Humanistic-social environment
(a) the number of population
(b) cultural education
(c) interpersonal relationship
(d) scientific management
(e) medical care services system
3) Therapeutic environment
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(a) Definition: It is an environment that created by
professionals aimed to fit the recovery of clients’ physiological and
psychological health
(2) Functions:
(a) influencing clients’ feeling
(b) influencing the course and degree of disease’s recovery.
(3) Requirement:
(a)safety
a) to prevent the accident’s occurrence
b) to avoid the spread of microorganism
(b)comfort
a) good physical environment
b) good services and attitude
2. Relationship among environment, human being and health
(1) Human being and its environment are interdependent and
interacted
(2) Human being’s health is closely linked with the environment
Health
1. Concept of health
(1) Definition of health
1) Absence of disease
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2) Feel comfort
3) Well-balanced functional activities
4) Well-balanced physiological and psychological activities
5) WHO--- The World Health Organization:
“a state of complete physical, mental and social well-being,
and not merely the absence of disease or infirmity.” (holistic view
of health)
(2) Models of health
--- Health-illness continuum model
1) Definition: Health and illness or disease can be viewed as the
opposite ends of a health continuum. From a high level of health a
person’s condition can move through good health, normal health,
poor health, and extremely poor health, eventually to death.
People move back and forth within this continuum day by day.
There is no distinct boundary across which people move from health
to illness or from illness back to health. How people perceive
themselves and how others see them in terms of health and illness will
also affect their placement on the continuum.
2) Characteristics:
(a) At any time any person’ health status holds a place on
certain point between two ends of health-illness continuum
(b) any point on the health-illness continuum is a synthetical
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representation of various (all) aspects of individual in physiology,
psychology, and society.
3) Nurses’ responsibility:
(a) to help the clients to identify their place (location) on the
health-illness continuum
(b) to assist the clients to adopt some measures (take actions)in
order to reach a well state of health.
(3) Factors that affect health
1) Biological factors:
(a)Pathogenic microorganism
(b) Biologic-heredity factor
(c) Other factors: age, sex, growth and development
2) Environmental factors
(a) Natural environment: air pollution, climate, water
pollution, soil pollution, radiation, noise.
(b) Social environment:
a) political and economic system in the society
b) social and cultural system
3) Life style:
4) Psychological factors
Psychological factors → emotion, feelings →
Physiological
function
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2. Concept of disease
(1) Definition of disease
1) Ancient view of disease
(a) Ghosts and gods attach to the body
(b) Unbalance between negative and positive
2) Modern view of disease
(a) A state that is treated by physician and falls short of the
needs of human being
(b) Be discomfort, suffering and pain
(c) A loss and change of social behaviors, especially the loss
and change of labour force
(d) An abnormity of function, structure and shape of
organism
(e) The destroy of homeostasis of organism
(f) A reaction of the organism to harmful factors
3) Disease:
(2) Effect of disease
1) The effect on individual
(a) Positive effect
(b) Negative effect:
2) The effect on family
(a) Economic burden is increased
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(b) Family member’s psychological stress is increased
(c) The emotion change of family member
3) The effect on society
(a) Social productivity is decreased
(b) medical resources are consumed or wasted
(c) to infect others and threaten other’s health
(3) Measures of preventing disease
1) Primary prevention (etiological prevention)
2) Secondary prevention (pre-clinical prevention)
“Three early” : To discover early
To diagnose early
To treat early
3) Tertiary prevention (clinical prevention)
3. The relationship between health and illness
(1) No distinct boundary. A relative relationship
(2) Be dynamic changing
(3) Be mutual transform under definite condition
(4) Be exist at the same time on one individual
Nursing
1. Concept of nursing
(1) Definition of nursing
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1) Nightingale’s definition of nursing
2) Henderson’s definition of nursing
3) American Nurse Association’s definition of nursing
4) International Council of nurses’ definition of nursing
(2)The content of concept of nursing
1) The nursing science is an independent applying science that
synthesizes natural and social science.
2) Nursing is a profession that helps human being and serves for
health of human being
3) Nursing can assist individual to meet the basic needs of
human being and enforce the ability of self-care.
4) The tasks of nursing are:
(a) to promote health
(b) to prevent disease
(c) to help ill-person to healing (to assist healing)
(d) to assist the dying patient to pass away with quietude,
peace, and dignity. (to ease suffering)
5) The client is a holistic human being, including suffering
person and healthy person.
6) The working place is not only in the hospital, but also in
family, community and whole society.
7) Nursing is not only a science, but also an art.
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8) The nursing science attaches importance to human being’s
living environment and the interrelation between human being and
its environment.
9) The nursing science is a gradually perfect and developing
science.
(3) Basic connotation of nursing (core)
1) Caring: lasting topic→to provide nursing care to the clients
2) Humanism: humanistic perspective
(a) to respect individual
(b) to pay attention to the human nature
(c) to treat equally without discrimination
3) a helping relationship
2. Evolvement process of the concept of nursing
(1) Developmental stages of nursing model
1) Stage 1:
disease-centered stage: to pay attention to the
disease not to the person; to follow the physician’s order
2) Stage 2: patient-centered stage: to use the nursing process to
give the holistic care to the patients----to collect patient’s data; to
make nursing diagnosis; to establish nursing care plan; to
implement the nursing care plan; to evaluate the achievement of
nursing objectives. Nurses’ client is merely the ill person and
nurses’ working place is merely in the hospital.
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3) Stage 3: health-centered stage: Nurses pay attention to a
person’s health. Nurses’ clients include not only ill persons but also
healthy persons. Nurses’ working place is not only in the hospital,
but also in the family, community and society.
(2) The meaning and significance of holistic nursing
1) The meaning of holistic nursing
(a) Definition of holistic nursing
(b) Connotation of holistic nursing
a) to meet client’s holistic needs
(physiological, psychological, social, spiritual, cultural )
b) to serve for the whole life course of human being
c) to serve for individual, family, community and society
2) Significance of holistic nursing
(a) To enrich and change the direction and content of nursing
research
(b) To widen the service areas of nursing and to change the
traditional image of nurses
(c) To contribute to establish a new type relationship between
physician and nurse, and relationship between nurse and
patient
(d) To propose a new type view of nursing administration
and leadership
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(e)To change the curriculum design of nursing education
3. The relationship between nursing and health
(1) WHO(1978) : “……to help patient to resume to health , help
healthy person to promote health.”
(2) ICN: right and obligation of nurses is:
1) To maintain life
2) To lighten (decrease) suffering
3) To promote health
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